带感觉指固有动脉穿支V-Y推进皮瓣修复手指软组织缺损的临床应用  

Clinical application of the dual V-Y advancement flap based on proper digital artery perforator with sensory reconstruction for repair of soft tissue defects of fingers

作　　者：李海[1] 魏在荣[1] 孙广峰[1] 唐修俊[1] 邓呈亮[1] 聂开瑜[1] 金文虎[1] 王达利[1] Li Hai;Wei Zairong;Sun Guangfeng;Tang Xiujun;Deng Chengliang;Nie Kaiyu;Jin Wenhu;Wang Dali(Department of Burns and Plastic Surgery,the Affiliated Hospital of Zunyi Medical College,Guizhou563003,China)

机构地区：[1]遵义医学院附属医院整形烧伤整形外科,贵州563003

出　　处：《中华手外科杂志》2018年第6期401-403,共3页Chinese Journal of Hand Surgery

基　　金：国家临床重点专科项目[国卫办医函(2013)544号];贵州省优秀青年科技人才培养对象专项基金[黔科合人字(2013)12号].

摘　　要：目的 探讨带感觉指固有动脉指背穿支V-Y推进皮瓣在修复手指中段皮肤软组织缺损中的可行性。方法 自2012年1月至2016年12月,我们对18例除末节以外不同节段指背皮肤软组织缺损患者,均采用创面近远端带指固有神经指背分支的指固有动脉指背穿支V-Y推进皮瓣修复。结果 术后皮瓣及供区均Ⅰ期愈合,所有患者均获得随访,时间为3~22个月,平均11个月,皮瓣及手指外形、质地良好。术后3个月随访患者手指主动活动度(TAM):优13例,良4例,可1例;皮瓣感觉功能评定:S3 2例,S3+ 4例,S4 12例。结论 利用创面近远端带指固有神经指背分支的指固有动脉指背穿支V-Y推进皮瓣修复指背皮肤软组织缺损,该方法安全简便、成活率高,术后感觉恢复较好,患指外形满意。Objective To explore the feasibility of the dual V-Y advancement flap based on proper digital artery perforator with sensory reconstruction for repair of soft tissue defects in the middle part of the fingers.Methods From January2012to December2016,18patients with soft tissue defects of the dorsal fingers in different segments except for the distal segment were treated by V-Y advancement flap based on proper digital artery dorsal perforator with dorsal branch of proper digital nerve near the proximal and distal wounds.Results The flap and donor site achieved primary healing.All the patients were follow-up from3 to22months with an average of 11months.The appearance and texture of the flap and finger were good.Three months after the operation,the results of TAM were excellent in13cases,good in4cases and fair in1case.The sensory recovery of flaps was evaluated asS3in2cases,S3+in4cases,S4in12cases.Conclusion The application of V-Y advancement flap based on proper digital artery dorsal perforator with dorsal branch of proper digital nerve near the proximal and distal wounds to repair the soft tissue defects of the dorsal fingers has the advantages of safety and convenience with high survival rate,good postoperative sensory recovery and satisfactory appearance of the iniured fingers.

关 键 词：指损伤 外科皮瓣 指固有动脉穿支 感觉重建 

分 类 号：R658.2[医药卫生—外科学]