小型腓浅动脉穿支皮瓣在手指软组织缺损中的应用  

Repair of the finger soft-tissue defects with mini superficial peroneal artery perforator flaps

作　　者：李建杭[1] 王洪刚[2] 赵军[1] 陈海生[1] 曾昕明[1] 王鹏程[1] LI Jianhang;WANG Honggang;ZHAO Jun(Department of Hand and Foot Microsurgery,Dongguan people's Hospital,Dongguan,Guangdong,523000,China)

机构地区：[1]东莞市人民医院手足显微外科,广东东莞523000 [2]中山大学附属第一医院显微创伤手外科,广东广州510080

出　　处：《实用手外科杂志》2019年第4期383-385,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨应用小型腓浅动脉穿支皮瓣修复手指皮肤软组织缺损的临床疗效。方法 2016年10月-2018年12月,应用小型游离腓浅动脉穿支皮瓣修复手指皮肤软组织缺损8例,其中5例皮瓣携带部分腓浅神经移植。分别采用面积为1.0 cm×1.5 cm^3.0 cm×4.0cm的小型游离腓浅动脉穿支皮瓣,移植修复手指软组织缺损,小腿供区直接Ⅰ期缝合。结果术后8例皮瓣顺利成活,Ⅰ期愈合6例,2例皮瓣边缘出现坏死,经清创换药后Ⅱ期愈合。其中4例皮瓣臃肿择期行皮瓣整形修薄。小腿供区切口全部Ⅰ期愈合良好。术后随访3~9个月,平均5.6个月。皮瓣外观良好,质地柔软,其中携带神经移植感觉恢复良好。结论小型游离腓浅动脉穿支皮瓣厚度适中,解剖较恒定,血供可靠,切取容易,不牺牲动脉主干,可携带腓浅神经分支与受区指神经接合,同时修复受区感觉,供区相对隐蔽,直接缝合愈合良好,是修复手指皮肤软组织缺损的有效方法。Objective To explore the clinical effects of mini free flap pedicled with superficial peroneal artery perforator on repair of soft-tissue defects in fingers. Methods From Oct 2016 to Dec 2018, 8 patients with soft-tissue defects in finders were repaired by mini free flap pedicled with superficial peroneal atery perforator. 5 cases of them carried partital superficial nerve transplantation in the skin, and the flap harvesting area varied from 1.0 cm ×1.5 cm ~3.0 cm ×4.0 cm to repaire the finger soft-tissue defect. The donor sites were primarily and directly closed. Results All 8 flaps survived. 6 cases obtained primary healing. Two of them experienced necrosis in skin edge, which healed by dressing change. 4 cases with bloated shape were modified. All donor sites of the leg obtained primary healing. 8 patients were followed up for 3 to 9 months(mean, 5.6 months). All the flaps had satisfactory appearance, texture,and the sensation of flaps which carried nerve graft were well restored. Conclusion The mini free flap pedicled with superficial peroneal artery perforator has constant anatomy, reliable blood supply, and good texture.The thickness of the flap is adequate and the dissection is easy, without sacrificing the main artery.It can carry the superficial peroneal nerve to anastomosis the digital nerve for repairing the sense of the recipient area. The donor area is relatively hidden, can be primarily and directly closed. This flap transplantation is an effective method to repair the soft-tissue defects in fingers.

关 键 词：手指软组织缺损 腓浅动脉穿支皮瓣 移植 修复 

分 类 号：R658.2[医药卫生—外科学]