应用足底内侧静脉皮瓣修复手指不同部位皮肤软组织缺损  

Medial pantar venous flap for reconstruction of different locations of digital soft tissue defects

作　　者：杨锦[1] 杨晓东[1] 丁建波[1] 周阳[1] 陈逸民[1] 付尚俊[1] 刘杨武[1] 楼旭鹏[1] 

机构地区：[1]温州医科大学附属义乌医院手足外科,322000

出　　处：《中华创伤杂志》2014年第6期579-583,共5页Chinese Journal of Trauma

基　　金：义乌市科研计划资助项目（12-3-23）

摘　　要：目的探讨应用足底内侧静脉皮瓣修复手指不同部位皮肤软组织缺损的手术方法及临床效果。方法2010年3月～2012年4月应用游离足底内侧静脉皮瓣修复手指不同部位创面29例（31指），其中指端缺损11例（13指），指背缺损7例（7指），指腹缺损11例（11指）。缺损范围1．2cm×1．5cm-2．5cm×3．5cm。术中切取大小1．5cm．×2．0cm-3．0cm×4．0cm足底内侧静脉皮瓣修复缺损。供区全部采用全厚皮片植皮。结果术后皮瓣全部成活。1例皮瓣术后出现动脉危象，2例皮瓣出现静脉危象，予以及时探查，重新吻合动静脉后皮瓣成活。创面Ⅰ期愈合。供区切口Ⅰ期愈合，植皮全部成活。24例26指（5例失访）术后随访4～12个月，指背外形满意，皮瓣色泽、质地与周围正常皮肤相似。指端及指腹缺损修复后有指纹，恢复保护性感觉。结论应用足底内侧静脉皮瓣修复手指皮肤软组织缺损成活率高，术后效果好，是修复手指皮肤软组织缺损的一种较理想方法。Objective To investigate procedures and clinical effects of medial plantar venous flaps in reconstruction of different sites of finger soft tissue defects. Methods From March 2010 to April 2012, 29 cases （31 fingers） of soft tissue defects in different sites were treated with medial plantar venous flaps, including 11 finger tip defects （13 fingers）, 7 finger back defects （7 fingers）, 11 finger pulp defects （ 11 fingers）. Size of the defects ranged from 1.2 cm × 1.5 cm to 2.5 cm × 3.5 cm. Size of the flap ranged from 1.5 cm ×2.0 cm to 3.0 cm × 4.0 cm. Donor sites were covered with full thickness skin graft. Results ALL flaps survived, except for one with arterial crisis and two with venous crisis, which were cured after timely vascular exploration and arteriovenous anastomosis. Donor and recipient sites were healed by first intention and skin grafts in donor sites survived. Twenty-four cases （26 fingers） were followed up for 4 to 12 months. Texture and color of the flaps were similar to those of adjacent normal skin, with a satisfactory appearance. Fingerprint and protective sensation were attained for soft tissue defects of the finger tip and pulp after operation. Conclusion Medial plantar venous flap is an ideal surgical option for reconstruction of finger soft tissue defect, for it has advantages of good effect and less damage to donor sites.

关 键 词：外科皮瓣 手 软组织损伤 修复 

分 类 号：R658.2[医药卫生—外科学]