指动脉皮支血管螺旋桨皮瓣修复儿童拇指指端皮肤缺损  

Propeller flap with cutaneous branch of digital artery for skin defect at children＇ s thumb tip

作　　者：杨颇[1] 金鑫[1] 周家顺[1] 陶磊[1] 何宣林 宋开芳[1] 

机构地区：[1]贵阳市第四人民医院显微创伤骨科,550002

出　　处：《中华整形外科杂志》2017年第4期252-255,共4页Chinese Journal of Plastic Surgery

摘　　要：目的总结以指动脉皮支血管为蒂的螺旋桨皮瓣修复儿童拇指指端皮肤缺损的效果。方法2012年12月至2015年10月，收治儿童拇指指端皮肤缺损共12例，皮肤软组织缺损平面均在甲根部以远，甲床完全存留4例，部分缺失8例。皮肤缺损范围1.0 cm×1.0 cm～1.5 cm×2.0 cm。利用拇指尺侧指动脉在创面边缘发出的皮支血管为皮瓣的蒂部，紧贴创面边缘在拇指侧方设计三角形皮瓣，皮瓣切取后呈螺旋桨状转移修复缺损。皮瓣供区游离植皮修复。结果皮瓣切取范围为1.0 cm×1.0 cm～1.5 cm×2.0 cm，术后皮瓣和植皮均成活，所有创面一期愈合。患儿均获得6～12个月随访，平均8个月，皮瓣质地柔软、色泽满意，指端饱满；指甲生长正常，拇指外观满意。术后6个月根据中华医学会手外科分会上肢部分功能评定试用标准，优9例，良3例。结论以指动脉皮支血管为蒂的螺旋桨皮瓣修复儿童拇指指端皮肤缺损，手术操作便捷，创伤小，静脉回流好，拇指外观良好，功能恢复满意。ObjectiveTo summarize the effect of propeller flap pedicled with cutaneous branch of digital artery for skin defect at children’s thumb tip.MethodsFrom December 2012 to October 2015, 12 children with skin defects at thumb tip were treated. The nail matrix was kept in 4 cases, partly injuried in 8 cases. The skin defects size ranged from 1.0 cm×1.0 cm to 1.5 cm×2.0 cm, all more than the size of nail roots. A triangular flap on lateral side of thumb was designed with cutaneous branch of digital artery on thumb ulnar side at wound edge. The defects at donor sites were covered with skin grafts. ResultsThe flap size ranged from 1.0 cm×1.0 cm to 1.5 cm×2.0 cm. All the flaps and skin grafts survived with primary healing. The children were followed up for 6-12 months（average, 8 months）. The flaps had soft texture and good color match and thickness. The cosmeticresult was satisfactory with normal nail growth. According to the standard of the hands of the Chinese Medical Association functional evaluation trial, the hand function was assessed as excellent in 9 cases, good in 3 cases 6 months after operation.ConclusionsPropeller flap with cutaneous branch of digital artery is suitable for the skin defect at children’s thumb tip with both satisfactory cosmetic and functionalresult . Themethod is easily performed with reliable venous drainage and less morbidity.

关 键 词：儿童 拇指 皮肤缺损 指动脉 外科皮瓣 

分 类 号：R726.5[医药卫生—儿科]