手指带蒂皮瓣逆行转移修复指端缺损的临床观察  

Clinical study of reverse island flaps in treating extrusive fingertip defects

作　　者：林宏伟[1] 邹育才[1] 赵资坚 肖瑛[1] 林秋萍[1] 

机构地区：[1]汕头市第二人民医院外二科,广东汕头515011

出　　处：《实用手外科杂志》2015年第2期179-180,183,共3页Journal of Practical Hand Surgery

摘　　要：目的 介绍几种手指带蒂皮瓣逆行转移修复指端缺损的临床应用体会.方法 总结3年来应用的几种手指带蒂逆行皮瓣治疗的86指指端缺损的临床资料,其中指固有动脉逆行岛状皮瓣32指,指背皮神经营养血管逆行皮瓣19指,指背浅静脉逆行皮瓣10指,指背筋膜蒂逆行皮瓣25指.结果 皮瓣完全坏死0指,皮瓣远端部分坏死12指;伤口感染7例,感染率8.1%.术后随访1.5-9个月,平均5.5个月.手指外观及功能恢复基本满意,患者能恢复劳动功能. 结论 手指掌背侧组织结构及生理功能明显不同,合理处理蒂部组织,保证有足量的蒂部组织以形成筋膜微血管网络,为皮瓣提供顺畅的静脉、淋巴回流渠道是各种手指带蒂逆行皮瓣手术成功的关键.Objective To retrospectively review the results of four kinds of reversed island flaps in treating fingertip defects. Methods 86 cases of fingertip defects have been treated in our section in the last three years. The cases include 32 fingers were repaired by digital artery retrograde island flaps, 19 fingers by digital dorsal neurocutaneous vascular retrograde flaps, 10 fingers by digital dorsal venous retrograde flaps, 25 fingers by digital dorsal fascial retrograde flaps. Results None has complete necrosis, 12 flaps had partial necrosis in the distal end; 7 flaps have wound infections, the infection rate is 8%. Followed-up 1.5 to 9 months （mean 5.5 months）, the finger＆#39;s appearance and function were satisfactory, atient can regain the ability to work. Conclusion The structure and function of palmar and dorsal of finger are obvious different.Well-done of the pedicle, being sure of that there has enough tissue to form fascial micro-vascular network, providing unobstructed veinous and lymphoid backflow channels for flap are the keys to successful operation of all kinds of digital reverse island flaps.

关 键 词：手指 指端缺损 修复 逆行皮瓣 临床研究 

分 类 号：R658.2[医药卫生—外科学]