以指动脉皮穿支蒂接力皮瓣修复指端皮肤软组织缺损  

Reconstruction of soft tissue defects at finger tip with relay flaps pedicled by perforator from digital artery

作　　者：周晓[1] 薛明宇[1] 许亚军[1] 强力[1] 黄军[1] 

机构地区：[1]无锡市手外科医院手外科无锡市第九人民医院,214062

出　　处：《中华整形外科杂志》2015年第6期422-425,共4页Chinese Journal of Plastic Surgery

摘　　要：目的 探讨以指动脉皮穿支蒂接力皮瓣修复指端皮肤软组织缺损的方法及疗效.方法 2012年3月至2014年6月,对9例指端皮肤软组织缺损的病例,采用指侧方指动脉皮支链皮瓣修复,皮瓣大小为1.3 cmx1.6 cm-1.6 cmx2.2 cm.同时,设计近创面指动脉指蹼穿支蒂V-Y推进皮瓣接力修复供区.结果 术后9例18块皮瓣完全成活,创面一期愈合,供区切口一期愈合.术后随访5个月至2年,平均12个月,皮瓣外观及弹性好,伤指无疼痛;指端皮瓣静止两点辨距觉为7-8 mm,指蹼穿支皮瓣静止两点辨距觉为10- 12 mm.手功能按ATM法评定：优7例,良2例.冬季患指无皮温低和怕冷等现象,皮瓣供区指蹼大小和深度无影响,无瘢痕挛缩,指蹼最大外展达30°- 40°结论 采用指动脉皮支蒂接力皮瓣修复指端皮肤软组织缺损,操作简单,术后疗效满意,不牺牲主干血管,供区可直接缝合,并避免了移植皮片的弊端.Objective To investigate the application of relay flaps pedicled by perforator from digital artery for reconstruction of soft tissue defects at finger tip.Methods From Mar.2012 to Jun.2014, 9 cases with soft tissue defects at finger tip were reconstructed with relay flaps at one side of finger pedicled by perforator from digital artery.The flap size ranged from 1.3 cm x1.6 cm to 1.6 cm x 2.2 cm.The defects at donor sites were covered by adjacent web perforator V-Y advanced flaps.Results All the 18 flaps in 9 cases survived completely with primary healing both in recipient and donor sites.The patients were followed up for 5 months to 2 years （average, 12 months） with good elasticity and cosmetic results.No pain happened in the treated finger.The 2-point discrimination distance was 7-8 mm in fingertip flaps, and 10-12 mm in web perforator flaps.Hand function was graded as excellent in 7 cases, good in 2 cases, based on ATM assessment.The affected fingers had normal temperature and cold-resistance during winter.The width and depth of web in the donor site were not affected.Conclusions The relay flaps pedicled by perforator from digital artery can be applied for reconstruction of soft tissue defects at finger tip.The procedure is easy with satisfactory results and reservation of main artery.No skin graft is necessary for closure of defects on donor sites.

关 键 词：外科皮瓣 指损伤 

分 类 号：R658.2[医药卫生—外科学]