动脉化静脉皮瓣Ⅰ期塑形修复指腹及甲廓缺损  

The arterialized venous flap for one-stage repairing finger pulp and nail folds defect

作　　者：李亮[1] 高增阳 万华[1] 李程科 何明飞[1] 黄忠明[1] 雷彦文[1] 张敬良[1] 

机构地区：[1]广州中医药大学顺德和平外科医院手显微外科,广东省佛山市528308 [2]顺德区桂洲医院手足外科

出　　处：《中华显微外科杂志》2016年第6期552-554,共3页Chinese Journal of Microsurgery

基　　金：佛山市顺德区2014年医学科研立项课题（2014041）

摘　　要：目的：总结动脉化静脉皮瓣Ⅰ期塑形修复拇、手指指腹及甲廓皮肤缺损的方法及效果。方法2013年3月至2015年10月，根据患指缺损大小及血管修复的要求，采用以患肢前臂动脉化静脉皮瓣Ⅰ期塑形修复拇、手指指腹及甲廓缺损32例，其中24例并有指骨骨折，8例并有指固有神经缺损。缺损面积2．0 cmx1．8 cm -4．3 cm x2．4 cm ，切取皮瓣最小面积为1．1 cm x1．0 cm -1．5 cmx1．3 cm ，最大面积为3．0 cm x2．2 cm -4．1 cm x4．5 cm。供区取中厚皮片移植修复，打包加压包扎。结果1例皮瓣因蒂部缝合过紧，术后发生血液循环障碍，经间断拆线后解除。2例皮瓣术后出现水泡，1周后消失。其余皮瓣均顺利成活，切口及供区植皮均Ⅰ期愈合。20例患者术后随访3-10个月（平均6．5个月），均采用患者来门诊复查进行直接回访。主要随访皮瓣外形、质地、感觉及供区恢复情况。随访截止时间为2016年4月。静态两点分辨觉为5．0-7．5 mm。指腹外形饱满，弹性好，耐磨，甲廓形态逼真。根据中华医学会手外科学会上肢部分功能评定试用标准评定，优28例，良4例。结论采用游离动脉化静脉皮瓣可以作为一种Ⅰ期塑形修复手指指腹及甲廓皮肤缺损的较好方法。Objective To summarize the method and effect of the arterialized venous flap for one- stage re-pairing finger pulp and nail folds defect. Methods From March, 2013 to October, 2015, 32 cases of cubitus arterial-ized venous flap of affected limbs one-stage for repairing finger pulp and nail folds defect. Results All cases of flaps were survival. The patients were followed up from 3 to 10 months （average 6.5 months）, and the static two-point dis-crimination was 5.0-7.5 mm. All refers to the finger pulp appearance was full, the elasticity was good, wear-resisting, armour profile shape lifelike. According to the Standard Functional Evaluation Issued by Hand Surgery Association of Chinese Medical Association, 28 cases were evaluated as excellent, 4 cases were as good, the rate of excellent or good results being 100%. Conclusion Dissociative arterialized venous flap can be used as a good method for one-stage re-pairing finger pulp and nail folds defect.

关 键 词：指损伤 塑形 静脉皮瓣 动脉化 甲廓 修复 

分 类 号：R658.2[医药卫生—外科学]