单向或反向双V—Y推进皮瓣在治疗指背皮肤缺损中的应用  

Clinical application of antegrade or retrograde double V-Y advancement flap in repairing skin and soft tissue defect of the dorsal linger

作　　者：肖志宏[1] 邢丹谋[1] 任东[1] 冯伟[1] 陈焱[1] 王欢[1] 赵志明[1] 张燕宾[1] 彭正人[1] Xiao Zhihong Xing Danmou Ren Dong Feng Wei Chen Yan Wang Huang Zhao Zhiming Zhang Yanbin Peng Zhengren.(Department of Hand Surgery, Wuhan Puai Hospital, Wuhan 430033, Chin)

机构地区：[1]武汉市普爱医院武汉市骨科医院手外科,湖北430033

出　　处：《中华手外科杂志》2017年第4期241-243,共3页Chinese Journal of Hand Surgery

基　　金：国家自然科学基金青年科学基金资助项目（81401834）;湖北自然科学基金青年科学基金资助项目（2014cfb363）;武汉市卫生局科技基金资助项目（WX14818）

摘　　要：目的介绍单向或反向双V～Y推进皮瓣修复指背皮肤缺损的方法及疗效。方法自2008年1月至2015年1月我科设计并采用单向或反向双V—Y推进皮瓣修复13例指背皮肤缺损，男5例，女8例；年龄18～60岁，平均28岁。示、中指各2例，环指8例，小指1例。肿块切除术后8例，手指外伤后腱骨外露5例。对缺损长度〈1．0cm的皮肤缺损，用单向V—Y推进皮瓣修复；对缺损长度1．0—1．5cm的皮肤缺损，用反向双V—Y推进皮瓣修复。结果13例皮瓣均未发生血液循环障碍及感染，全部存活，伤口Ⅰ期愈合。随访3-24个月，皮瓣质地、色泽、外形良好，皮瓣的切取未对邻近关节活动产生明显影响。结论该皮瓣具有操作简单、外形良好、相邻关节活动不因皮瓣解剖受到明显影响等优点，是修复指背皮肤缺损的良好方法。Objective To introduce the surgical technique and treatment outcomes of antegrade or retrograde double V-Y advancement flap to repair soft tissue defect of the dorsal finger. Methods From January 2008 to January 2015, 13 cases （13 fingers） of finger skin and soft tissue defects were treated with the antegrade or retrograde double V-Y advancement flap. There were 5 males and 8 females, with ages ranging from 18 to 60 years （average, 28 years）. The fingers involved were index finger in 2 cases, middle finger in 2 cases, ring finger in 8 cases and 1 case of little finger. Among which 8 cases were due to tumor resection and 5 acute finger injuries. For defects less than 1.0 cm in length, the antegrade V-Y advancement flap was used. For defects with a length between 1.0 to 1.5 cm, retrograde double V-Y advancement flap was transferred. Results All the flaps survived completely without blood supply compromise and infection. All the incisions healed by first intention. These cases were follow-up for 3 to 24 months postoperatively. The texture and color of the flaps were satisfactory matching the neighboring tissues. The joints adjacent to the flap had no limitation in flexion and extension. Conclusion The antegrade or retrograde double V-Y advancement flap has advantages of simple dissection, satisfactory appearance, and normal range of motion of the joint. It is an effective procedure for coverage of skin and soft tissue defect of the dorsal finger.

关 键 词：指损伤 外科皮瓣 治疗结果 

分 类 号：R658.2[医药卫生—外科学]