指固有神经背支营养血管皮瓣修复手指皮肤软组织缺损的临床观察  

Repair of finger skin and soft tissues defects with the dorsal branch nutrient vessel flap of digital proper nerve

作　　者：王思夏[1] 战杰[1] 石强[1] 吴锦生[1] 孙鹏[1] 

机构地区：[1]沈阳医学院附属中心医院手外四科,辽宁110024

出　　处：《中国美容整形外科杂志》2015年第1期24-26,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨指固有神经背支营养血管皮瓣修复手指皮肤软组织缺损的临床效果.方法 以指固有神经背支的走行方向为轴线,设计并切取皮瓣,将皮瓣转移修复手指皮肤软组织缺损,皮瓣而积1.2 cm×1.5 cm～2.0 cm×3.7 cm,供区直接缝合或游离植皮覆盖创面.结果 本组49例（63指）皮瓣均成活,其中4例（5指）皮瓣术后出现表皮下淤血或水泡,2例（2指）皮瓣远端边缘部分表浅坏死,经换药后愈合.45例（58指）皮瓣获得随访,随访3 ～ 18个月,皮瓣弹性、质地良好,外形饱满;4例（5指）皮瓣失访.皮瓣两点辨别觉为5 ～ 10 mm.结论 应用指固有神经背支营养血管皮瓣修复手指皮肤软组织缺损,可避免损伤主要神经血管,是一种简单、成活率高、疗效满意的手术方法,值得临床推广应用.Objective To investigate the clinical effect of the dorsal branch nutrient vessel flap of digital proper nerve on repairing finger skin and soft tissue defects. Methods The extending direction of digital proper nerve was as axis, the dorsal branch nutrient vessel flap was harvested and transferred to repair finger skin and soft tissue defects, the sizes of flap were ranged from 1.2 cm×1.5 cm to 2.0 cm ×3.7 era. The donor sites were sutured directly or covered with free skin grafting. Results All flaps of 49 cases （63 fingers） survived. 4 cases （5 fingers） had signs of vacuoles or congestion and 2 cases （2 fingers） occurred superficial necrosis of distal edge, which healed after dressing changes with good blood supply. Follow-up was performed on 45 cases （58 fingers） for 3 to 18 months, all were satisfied with good elasticity, texture and satisfactory appearances of the flaps. The sensation of differentiation between two points on the flaps covered 5 to 10 mm. Conclusion The flap pedi- cled with ramus dorsalis nutrient vessel of digital nervous proprii is a simple method to repair finger skin and soft tissue defects with these advantages, like high survival rate, satisfactory operation and no major vascular injures. It is worthy spreading in clinical.

关 键 词：神经背支营养血管皮瓣 软组织缺损 皮神经 外科皮瓣 

分 类 号：R622[医药卫生—整形外科]