利用腕横纹皮瓣桥接修复手指皮肤合并指固有动脉复合缺损9例  

Surgical application of the free spbra flap for repairing composite tissue defects with 9 patients

作　　者：纪翔[1] 丁小珩[1] 刘育杰[2] 屈志刚[2] 姜凯[2] 张宏勋[2] 焦鸿生[2] 仲霄鹏[2] 刘春雷[1] 郑波[1] 

机构地区：[1]潍坊医学院,山东潍坊261053 [2]解放军第401医院全军手外科中心

出　　处：《青岛医药卫生》2015年第2期86-89,共4页Qingdao Medical Journal

摘　　要：目的探讨应用游离桡动脉掌浅支皮瓣修复手指掌侧皮肤合并指动脉复合组织缺损的临床疗效。方法 2010年10月至2014年4月收治9例手指掌侧皮肤合并指动脉缺损患者,切取桡动脉掌浅支皮瓣游离移植修复创面,同时利用该皮瓣中的桡动脉掌浅支桥接修复指固有动脉,恢复指体血运,供区直接缝合。结果术后皮瓣顺利成活,其中1例皮瓣近端部分皮肤血泡形成,经换药处理,创面愈合。9例患者均获随访,随访时间为6-12个月,平均8个月。皮瓣质地柔软,颜色与周围皮肤相似。供区一期闭合,瘢痕较隐蔽。末次随访时,患指功能根据总主动活动度评分法,获优6例,良2例,可1例,优良率88.9%。结论桡动脉掌浅支穿支皮瓣可做为血流桥接皮瓣,手术操作简单,供区损伤小,是修复手指掌侧皮肤合并动脉缺损的理想方法之一。Objective To investigate the outcome of the free flap from superficial palmar branch of radial artery for repairing composite tissue defects.Methods From October 2010 to April 2014,we repaired 9patients with finger composite defects with the SPBRA flap,used the SPBRA flap to repair the defects,at the same time,had the technique of flow-through to recover the blood supply of injured fingers.All the donor sites were directly closed.Results All flaps survived,and wounds healed by first intention;1case had partial blood blister and the wound recovered by changing dressing.All patients were followed up from 6to 12months（mean 8months）.The appearance,texture and color of the flaps were satisfactory.The donor sites healed primarily with the inconspicuous scars and no limitation of wrist flexion and extension.According to total active motion（TAM）standard,the finger function was assessed as excellent in 6cases,good in 2cases and fair in 1case,and excellent and good rate was 88.9%.Conclusion The SPBRA flap with flow-through technique is one of ideal flaps who appears less damage to repair composite defects.

关 键 词：桡动脉掌浅支 游离皮瓣 皮肤缺损 指动脉缺损 

分 类 号：R622.1[医药卫生—整形外科]