吻合掌侧静脉的游离第2足趾趾腹皮瓣修复手指指腹缺损  

Repair of finger pulp defect with free second toe pulp flap anastomosed with palmar vein

作　　者：宿晓雷[1] 余航[1] 常文利 张宁[1] 李统[1] 张学磊[1] 陈广先[1] 王鸿飞[1] 赵建勇[1] XIU Xiaolei;YU Hang;CHANG Wenli;ZHANG Ning;LI Tong;ZHANG Xuelei;CHEN Guangxian;WANG Hongfei;ZHAO Jianyong(Department of Hand Surgery,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei Province 061001,China)

机构地区：[1]河北省沧州中西医结合医院手显微外一科,河北沧州061001

出　　处：《中华显微外科杂志》2020年第3期254-256,共3页Chinese Journal of Microsurgery

摘　　要：目的探讨趾-指掌侧固有动脉、足趾跖侧及手指掌侧静脉吻合的游离趾腹皮瓣修复手指指腹缺损的手术方法和临床效果。方法自2018年4月至2019年11月,对15例手指指腹缺损的患者取第2足趾趾腹移植进行修复,术中吻合足趾跖侧静脉及手指掌侧静脉,吻合足趾及手指指掌侧固有动脉,缝接趾-指神经,皮瓣大小0.8 cm×0.5 cm^1.0 cm×1.2 cm。供区手术创伤较小,足趾创面一期缝合。结果15例皮瓣全部成活,无动、静脉危象发生。术后随访3~9个月,2例采用微信随访,9例通过电话随访,4例门诊随访,随访时间平均5.7个月。皮瓣血运良好,外形饱满,弹性较好,3个月后部分患者触觉恢复,4~6个月后痛觉部分恢复,足部供区外形较好,行走正常。结论吻合掌侧静脉的游离趾腹皮瓣修复手指指腹缺损,不用解剖指背侧静脉,足趾可直接缝合,供区损伤小,手术简便,临床效果较好。Objective To explore a surgical procedure of reconstruction finger pulp defect with free toes plantar flap with vascular anastomosis of toe-finger artery and plantar-palmar vein of finger.Methods From April,2018 to November,2019,15 patients with finger pulp defect were repaired by transplantation of the second toe pulp.In the procedure,the plantar vein of the toe and palmar vein of the finger were anastomosed.The artery and nerve of the toe and finger were anastomosed.The flap size was 0.8 cm×0.5 cm-1.0 cm×1.2 cm.The donor site was primary closed without deformity and other complication.Results All flaps survived without vascular crisis.The mean followed-up period was 5.7(range 3-9)months.The flaps had good blood flow,soft texture and good elasticity.Three months after surgery,touch sensation was partly recovered in some patients,and while pain was partly recovered in some patients 4-6 months after surgery.There was no deformity and other complication in the donor site.The donor sites of the foot had good appearance and normal walking function.Conclusion The free toe plantar flap anastomosed with palmar vein can repair the digital pulp defect without dissecting the dorsal vein of digital(toe),and the donor sites can be primary sutured without deformity and other complications.The surgery operation is simple with satisfactory clinical effect.

关 键 词：趾腹皮瓣 手外伤 指腹缺损 第2足趾 移植 

分 类 号：R658.2[医药卫生—外科学]