血管神经蒂V—Y皮瓣修复手指末节Ⅱ区皮肤缺损  

Application of neurovascular pedicle V-Y flap for repair of distal finger soft tissue defect in Ⅱ area

作　　者：周飞亚[1] 高伟阳[1] 吴剑彬[1] 蒋良福[1] 杨景全[1] 丁健[1] 褚庭纲[1] 

机构地区：[1]温州医科大学附属第二医院手外科,浙江325027

出　　处：《中华手外科杂志》2017年第5期364-366,共3页Chinese Journal of Hand Surgery

摘　　要：目的讨论以血管神经蒂V-Y皮瓣修复手指末节Ⅱ区皮肤缺损的操作方法、治疗效果及临床意义。方法自2014年5月至2016年8月，以血管神经蒂V—Y皮瓣修复12例12手指末节Ⅱ区皮肤缺损，患者均伴有肌腱或骨骼外露以及甲基质残留。切取皮瓣面积2．0cm×2．0cm-2．0cm×2．5cm，皮瓣供区直接缝合。结果术后12例12手指移植皮瓣完全存活。随访10例10指，失访2例。随访时间6—12个月，术后皮瓣外观满意，两点分辨觉为4-6mm。结论血管神经蒂V-Y皮瓣修复伴有肌腱骨骼外露手指末节Ⅱ区皮肤缺损是简单可靠的方法，能兼顾耐用性、外观及感觉恢复，且不产生供区伤害。具有良好的安全性和普及性。Objective To discuss the operation method, treatment effect and clinical significance of neurovascular pedicle V-Y flap for repair of distal finger soft tissue defect in Ⅱ area. Methods From May 2014 to August 2016, 12 cases （12 fingers） of distal finger soft tissue defect in Ⅱ area were treated with neurovascular pedicle V-Y flap. All the wounds were accompanied by tendon or bone exposure and onychostroma residual. The flap area ranged from 2.0 cm×2.0 cm to 2.0 cm×2.5 cm. The donor site was closed directly. Results All the 12 flaps of 12 fingers survived uneventfully. Ten cases were followup for 6 to 12 months, and 2 cases were lost. Postoperatively the flaps had satisfactory appearance with the two-point discrimination ranging from 4 to 6 ram. Conclusion The neurovascular pedicle V-Y flap is a reliable and safe way to cover the distal finger soft tissue defect in Ⅱ area with tendon or bone exposure, which has the advantages of durability, safety and popularity due to the appearance and sensory recovery and no damage to donor sites.

关 键 词：指损伤 外科皮瓣 皮肤缺损 神经血管蒂 v0皮瓣 

分 类 号：R658.2[医药卫生—外科学]