改良第一趾蹼皮瓣修复邻指大面积指腹并指蹼缺损  

Reconstruction of adjacent finger pulp and fingerweb defects by the modified first toe web flap

作　　者：李国强[1] 焦延杰 丘日升[1] 陈康察[1] 周健辉[1] 王夫平[1] 

机构地区：[1]南方医科大学附属小榄医院整形外科,广东中山528415 [2]邢台矿业集团总医院骨三科

出　　处：《中国美容整形外科杂志》2015年第12期733-735,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨应用改良第一趾蹼皮瓣修复相邻两指大面积指腹并指蹼缺损的临床效果。方法采用改良第一趾蹼皮瓣游离移植修复相邻两指大面积指腹并指蹼缺损9例。以第一趾蹼皮瓣为中心，联合拇趾腓侧皮瓣、第二趾胫侧皮瓣和足背皮瓣，形成“四合一”的改良第一趾蹼皮瓣，以扩大皮瓣修复面积；在修复指腹缺损的同时，重建指蹼。结果本组9例患者，术后皮瓣全部成活，其中2例发生静脉危象，予拆除部分缝线后缓解；2例趾蹼皮肤部分坏死，经二次植皮后愈合。随访6—35个月，皮瓣质地良好，指腹及指蹼外形与功能恢复满意，皮瓣供区隐蔽，无功能障碍。结论改良第一趾蹼皮瓣是修复邻指大面积指腹并指蹼缺损的较理想皮瓣，但需注意手术技巧。Objective To introduce clinical results of the modified first toe web flap in repairing the adjacent finger pulp and fingerweb defects. Methods Nine cases with adjacent finger pulp and fingerweb defects were repaired with the modified first toe web flap. The first traditional toe web flap as the center was combined with the fibular hallux flap, the tibial flap of second toe and the dorsal foot flap to form the modified first toe web flap which could enlarge the repairing area of the flap to reconstruct the adjacent finger pulp defects and fingerweb defects at the same time. Results All flaps survived except for 2 cases with venous crisis, which were reversed by removed some sutures and 2 eases with necrosis in part of the first web skin which were healed through the second operation of skin transplanting. All cases were followed up from 6 to 35 months. The texture of the flap, the shape and function of the finger and fingerweb were satisfactory. The donor site of the flap was covert, and the function of the foot was unaffected. Conclusion The modified first toe web flap is an ideal flap for reconstruction of adjacent finger pulp and fingerweb defects. To increase the successful rate of the operation, it is important to improve the operative skills.

关 键 词：指损伤 指蹼 外科皮瓣 显微外科 

分 类 号：R622[医药卫生—整形外科]