尺动脉近段血流桥接穿支皮瓣修复手掌部创面缺损  

Flow-through ulnar artery proximal perforator flaps for wound coverage of palm defects

作　　者：李涛[1] 陈振兵[1] 艾方兴[1] 丛晓斌[1] 田甲[1] 洪光祥[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院手外科,武汉430022

出　　处：《中华手外科杂志》2014年第4期271-274,共4页Chinese Journal of Hand Surgery

摘　　要：目的 探讨尺动脉近段血流桥接穿支皮瓣修复手掌部创面缺损的临床应用.方法 本组5例均为外伤导致手掌部皮肤、软组织缺损、血管损伤合并手指血运不良.2012年2月至10月我们应用尺动脉近段血流桥接穿支皮瓣修复创面,桥接了手掌部血管.术后超声检测桥接血管通畅情况,问卷调查患者对皮瓣外形的满意度,检测皮瓣触痛觉、温度觉、两点分辨觉,检查患指的关节活动度.结果 5例皮瓣均存活良好.随访时间为12～ 18个月,皮瓣较薄、外形良好,桥接血管血流均通畅,供区伤口均Ⅰ期愈合.患者对皮瓣外形满意度高（100％）,术后12个月皮瓣两点分辨觉恢复至7.3～ 12.1 mm,平均7.8mm,皮瓣感觉恢复至S3＋.结论 尺动脉近段血流桥接穿支皮瓣在修复手掌部创面的同时能重建断指血运,这是对细小穿支皮瓣的较好改进方法,具有特殊的适应证和应用价值.Objective To investigate the clinical application of flow-through ulnar artery proximal perforator flaps for wound coverage of palm defects.Methods From February 2012 to October 2012,flowthrough ulnar artery proximal perforator flap was used to treat 5 cases of traumatic skin and soft tissue defects of the palm along with metacarpal artery injury and compromised finger perfusion.The vessel of the flap was inset between the ends of the injured metacarpal artery to repair the metacarpal artery so both the flap and the fingers were perfused.Postoperatively patency of the vessel was monitored by ultrasound.Patients＇ satsfaction of flap aesthetics was assessed by a questionnaire.Pain,touch and temperature sensations,two-point discrimination and finger movement were tested.Results All five flaps survived well.The patients were follow-up for 12 to 18 months.The flaps were thin and had good appearance.The flow through vessel was patent in all the cases.Primary healing was achieved in the donor sites.The patients were highly satisfied with the appearance of the flap （100％）.Perception of pain,temperature and touch was restored at 6 months postoperatively,while two-point discrimination returned to 7.3 to 12.lmm at 12 months,with an average of 7.8 mm.S3＋ sensation was restored to the flaps.Conclusion Flow-through ulnar artery proximal perforator flaps are suitable for repairing some special wound defects with artery injuries by not only reconstructing skin defects of the palm,but also restoring blood circulation to the fingers.

关 键 词：尺动脉 指损伤 穿支 血流桥接皮瓣 

分 类 号：R658.2[医药卫生—外科学]