应用改良逆行岛状指背神经筋膜蒂皮瓣修复手指远端缺损  

Application of modified reverse island dorsal digital nerve fasciocutaneous pedicle flap in the repair of distal finger defects

作　　者：李友[1] 巨积辉[1] 徐磊[1] 段永明[1] 钟鸣 蒋国栋[1] LI You;JU Ji-hui;XU Lei;DUAN Yong-ming;ZHONG Ming;JIANG Guo-dong(Department of Hand Surgery,Ruihua Afiliated Hospital of Soochow Universily,Suzhou 215104,China)

机构地区：[1]苏州大学附属瑞华医院手外科,江苏苏州215104

出　　处：《中国美容整形外科杂志》2020年第7期415-417,共3页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：江苏省青年医学人才项目(QNRC2016224)。

摘　　要：目的探讨指背神经筋膜蒂皮瓣蒂部的改良对皮瓣成活的影响。方法自2016年6月至2018年9月,采用指背筋膜蒂皮瓣修复手指远端软组织缺损患者39例(43指)。在切取指背神经筋膜蒂皮瓣时,将蒂部设计成三角瓣(根据软组织的缺根损形状制作皮瓣为圆切角或椭圆切线夹角,以确定三角瓣的大小),以增加皮瓣蒂部的容积;术后观察指端皮肤软组织缺损修复的疗效。结果所有患者术后获随访3~24个月,皮瓣均成活良好,外观较满意。结论采用指背神经筋膜蒂皮瓣修复手指软组织缺损时,其蒂部设计成三角瓣对术后皮瓣血运及蒂部的减压有较好的效果。Objective To explore the effect of modification of dorsal digital nerve fasciocutaneous pedicle flap on flap survival.Methods From June 2016 to September 2018,39 patients(43 fingers)with distal finger soft tissue defects were treated by dorsal digital nerve fasciocutaneous pedicle flap.In the harvest of dorsal digital nerve fasciocutaneous pedicle flap,the pedicle was designed as a triangular flap to increase the dimension.According to the shape of soft tissue defects,the flap was made depend on the circular cut angle or the elliptical tangent angle to determine the size of the flap.The efficacy of distal finger soft tissue defects after operation was observed.Results All patients were followed up from 3 to 24 months after operation.All flaps survived well.The appearance was satisfactory.Conclusion In the repair of distal finger soft tissue defects with dorsal digital nerve fasciocutaneous pedicle flap,the pedicle was designed as a triangular flap to increase the blood supply and decrease the compression.Good recovery results could be achieved.

关 键 词：指损伤 外科皮瓣 皮瓣蒂部 修复缺损 改良术式 

分 类 号：R658.2[医药卫生—外科学]