改良第二掌背动脉复合皮瓣修复示中指背侧缺损  

Modified Second Dorsal Metacarpal Artery Composite Skin Flap Repairing the Dorsal Defect of Index and Middle Finger

作　　者：林泽金 吴耿 邓雪峰 陈飞强 黄定根 LIN Ze-jin;WU Geng;DENG Xue-feng;CHEN Fei-qiang;HUANG Ding-gen(Department of Trauma & Orthopedics,Central Hospital of Longhua,Shenzhen 518110,Guangdong,China)

机构地区：[1]深圳市龙华区中心医院创伤骨科

出　　处：《中国现代手术学杂志》2019年第4期285-288,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨改良第2掌背动脉复合皮瓣修复示中指复合组织缺损的临床效果。方法2013年10月~2018年6月我院收治示中指背侧皮肤合并伸肌腱复合缺损患者11例,其中左侧示指5例,左侧中指2例,右侧示指3指,右侧中指1例,均为近节中段以远皮肤缺损伴有肌腱缺损,缺损面积为(1.4cm×2.5cm)^(2.0cm×4.0cm)。均采用改良第2掌背动脉复合皮瓣进行修复。结果10例皮瓣Ⅰ期成活,1例皮瓣术后3d远端出现暗紫色张力性水疱,予抬高患肢、张力性水泡抽液、伤口换药、限制下床活动等措施治疗,水疱消退,无皮瓣坏死。术后随访10例,随访时间6~12个月。术后皮瓣质地柔软,两点辨别觉平均为(7.8±2.0)mm,皮瓣周边无触痛,皮瓣可见环形瘢痕,未见瘢痕挛缩,外观良好。手指功能按手指总主动活动度(TAM)法评定:优4指,良5指,可1指,优良率90%。结论改良第2掌背动脉复合皮瓣设计合理,皮瓣血供充分,手指功能恢复好,对供区影响甚微,可用于修复示中指背侧创面复合缺损。Objective To investigate the clinical effect of modified second dorsal metacarpal artery composite skin flap for repairing the complex tissue defect of index and middle finger.Methods From October 2013 to June 2018,a total of 11 patients with composite defect of extensor tendon and dorsal skin of index and middle finger were treated in our hospital,including 5 cases of left index finger,2 cases of left middle finger,3 cases of right index finger and 1 case of right middle finger.The defect area ranged from 1.4 cm×2.5 cm to 2.0 cm×4.0 cm.The modified second dorsal metacarpal artery composite skin flap was applied to repair the composite defect.Results Ten flaps survived in stageⅠ,and darkorchid tension hydroa appeared in the distal end of one flap and extincted after the injury finger lifted,hydroa liquid drawed,wound dressing changed and off-bed restricted.Ten cases were followed up for 6 to 12 months.The flaps were soft and good appearance with two-point discrimination of(7.8±2.0)mm averagely.According to TAM assessment,the finger function was excellent in 4,good in 5 and fair in 1,and the fineness rate was 90%.Conclusion The modified second dorsal metacarpal artery composite skin flap can be applied to repair the dorsal defect of index and middle finger with advantages of reasonable design,guaranteed blood supply,well restored finger function and less influence on donor site.

关 键 词：复合皮瓣 掌背动脉 指损伤 修复 

分 类 号：R622.1[医药卫生—整形外科]