微型游离皮瓣在修复多手指软组织缺损中的应用效果  

Clinical application of microfree skin flap in repairing soft tissue defect of multiple fingers

作　　者：向滔 田林 张晓星 刘小胜 石峰 XIANG Tao;TIAN Lin;ZHANG Xiaoxing(Department of Orthopaedic, The 4th Peopled Hospital of Chongqing City, Chongqing, 201205, China)

机构地区：[1]重庆市第四人民医院骨科,重庆201205 [2]重庆市长城医院创伤修复显微外科中心,重庆201205

出　　处：《实用手外科杂志》2019年第1期53-55,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨微型游离皮瓣在修复多手指软组织缺损中的应用效果。方法 2015年6月-2017年6月,对9例26指手指软组织缺损采用多个微型皮瓣修复,其中2指缺损3例,3指缺损4例,4指缺损2例。2指缺损采用双侧?趾腓侧皮瓣修复,3指缺损采用双侧?趾腓侧皮瓣及单侧足内侧皮瓣修复,4指缺损采用双侧?趾腓侧皮瓣及双侧足内侧皮瓣修复,皮瓣切取后供区均直接缝合。结果术后皮瓣全部成活,未发生血管危象,供区及受区伤口Ⅰ期愈合,平均随访时间18个月(范围3～24个月)。皮瓣质地、弹性良好,无皮瓣臃肿,外观饱满。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21指,良4指,差1指。指端静态两点辨别觉平均7.5 mm(范围6～9 mm)。结论应用微型游离皮瓣修复多个手指软组织缺损可有效重建患指外形及功能,长期疗效满意,是修复多个手指软组织缺损的理想方法之一。Objective To access the clinical utility of miniature free Flap to repair multi-digit soft tissue defect. Methods From June 2015 to June 2017, 9 cases of soft tissue defect in 26 digits were treated with multiple miniature free flap reconstructions, including 2 digits defect in 3 cases using bilateral fibular flap of the toe, 3 digits defect in 4 cases using bilateral fibular flap of the toe plus uniliateral medial pedal flap and 4 digits in 2 cases using bilateral fibular flap of the toe plus biliateral medial pedal flap. The doner site were directly closed in all cases. Results All flaps survived postoperatively without vascular crisis. Donor and recipient sites healed by first intention. With a mean follow-up of 18 months(ranged 3~24 months),all free flaps appeared to be in good texture, elasticity and aesthetics. According to CMAHS upper extremity scoring system, postoperative hand function were rated excellent in 21 cases, good in 4 cases and poor in 1 case. Static 2 point discrimination was 7.5 mm(ranged 6 mm^9 mm). Conclusion We can achieve a satisfactory long-term aesthetic and functional outcome of multiple digital soft tissue reconstruction using miniature free flap.

关 键 词：微型 游离皮瓣 软组织缺损 显微外科修复 

分 类 号：R658.2[医药卫生—外科学]