指动脉终末指背支逆行岛状瓣修复指端缺损的感觉功能评价  

Evaluation of Sensory Recovery of the Reverse Island Flap Based on the Digital Artery Distal Dorsal Branch for Fingertip Repair

作　　者：曹怡 杜子婧[1] 韩冬[1] 姜浩[1] CAO Yi;DU Zijing;HAN Dong;JIANG Hao(Department of Plastic aiul Reconstruction Surgery,Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科

出　　处：《组织工程与重建外科杂志》2019年第5期338-341,共4页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨伴有或不伴有神经吻合的指动脉终末指背支(Distal dorsal branch,DDB)逆行岛状瓣对于指端感觉恢复的影响。方法2014年9月至2018年5月,27例指动脉DDB皮瓣修复的指端缺损病例,分为吻合神经组和未吻合神经组,术后平均随访13.2个月(6~28个月),以Semmes-Weinstein(SW)单丝试验、静态和动态两点辨别觉来评价皮瓣感觉功能,以视觉模拟量表评估疼痛感,冷耐受度评分表检测皮瓣冷耐受。结果两组皮瓣均存活,外形满意。长期随访显示,吻合神经组与未吻合神经组的SW单丝试验结果、静态和动态两点辨别觉、皮瓣疼痛感和冷耐受度均无明显统计学差异。结论指动脉DDB皮瓣是指尖修复的一种选择。未吻合神经的DDB皮瓣可恢复感觉功能。Objective To evaluate the sensory recovery of both innervated and noninnervated homodigital island flaps based on the digital artery distal dorsal branch(DDB)for fingertip repair.Methods Twenty-seven cases of fingertip injuries repaired with DDB flaps were retrospectively investigated.Mean follow-up time was 13.2 months(6-28 months).Sensory recovery was assessed using SW monofilament,static and moving two-point discrimination tests.Pain and cold intolerance were respectively measured by visual analogue scale and Cold Intolerance Severity Score questionnaire.Results All flaps survived.Patients were satisfied with the fingertip appearance.Flap sensation had no significant difference in both innervated and noninnervated groups according to long-term follow-up.Conclusion The digital artery DDB flap is an alternative method for fingertip repair.Noninnervated DDB flap can restore flap sensation in long-term evaluation.

关 键 词：指端损伤 感觉恢复 同指皮瓣 指动脉终末指背支 

分 类 号：R622[医药卫生—整形外科]