跗外侧皮瓣转移修复手指皮肤软组织缺损的疗效分析  

Clinical application of free lateral tarsal flap transfer for repair of skin and soft tissue defect of the finger

作　　者：冯铁成[1] 范爱民[1] 何志[1] 张立亮[1] 

机构地区：[1]中国人民解放军第359医院手足显微外科,江苏镇江212001

出　　处：《实用手外科杂志》2017年第3期320-322,共3页Journal of Practical Hand Surgery

摘　　要：目的 探讨跗外侧皮瓣修复手指皮肤软组织缺损的方法及疗效.方法 2009年10月-2014年9月,应用跗外侧皮瓣修复手指皮肤软组织缺损11例.根据足的解剖学结构,设计以足背动脉为蒂的跗外侧动脉皮支穿出点为中心的皮瓣,皮瓣的足背外侧皮神经与手指指神经缝合,皮瓣的动脉与手指主要动脉吻合.足外侧供区取大腿外侧全厚皮片植皮修复.观察术后皮瓣成活情况、外形、色泽、感觉以及手指功能和供区恢复情况.结果 术后11例皮瓣全部成活,血运良好.供受区均Ⅰ期愈合.9例获随访,随访时间8个月~2年,皮瓣色泽逼真,外形不臃肿,触痛觉恢复,两点辨别觉7~9 mm,指间关节活动良好.足部供区无瘢痕挛缩,功能良好.结论 跗外侧皮瓣具有血管解剖恒定、皮瓣质量好等特点,是修复手指软组织缺损的有效方法,值得进一步推广.Objective To explore the method and curative effect of lateral tarsal flaps transplantation on repairing the digital soft tissue defect. Methods From October 2009 to October 2014, 11 cases of finger skin and soft tissue defect were treated by lateral tarsal flaps transplantation. According to the anatomy of foot, we designed the perforator branch of the lateral tarsal artery, which used the arteria dorsalis pedis as vessel pedicel, as a turning point. The nervus cutaneus dorsalis lateralis pedis of flap were anastomosed to the digital nerve, and the flap＇s artery was anastomosed with the fingers. The donor site of lateral foot was repaired by full-thickness skin of lateral thigh. After operation, survival condition, shape, color, sense, the recovery of finger＇s function and donor site of the patients were observed. Results All 11 cases of flaps survived after operation, and had abundant blood supply. Both donor and recipient site got primary healing. 9 cases were followed up, the period was 8 months to 2 years, the color of flaps was good, without the bloated shape, their algesia and tactile sensation recovered, and the two-point discrimination was 7 to 9 mm, and the interphalangeal joint had got good movement. The donor site of foot had without good function. Conclusion Lateral tarsal flap has the advantages of constant vascular anatomy and good quality, it is an effective method to repair the fingers＇ soft tissue defect and it is worth popularizing.

关 键 词：跗外侧皮瓣 手外伤 缺损 显微外科技术 

分 类 号：R473.6[医药卫生—护理学]