异形指动脉逆行岛状皮瓣修复手指中型创面  

Repair of digital middle-sized soft tissue defects by irregular reversed digital artery island flaps

作　　者：刘应良 丁艳芬 张文龙[2] 夏燕 余昌德 王敬 赵庆华 起家发 LIU Yingliang;DING Yanfen;ZHANG Wenlong(Department of Orthopedic,The People's Hospital of Chuxiong State,Chuxiong,Yunnan,675000,China)

机构地区：[1]楚雄州人民医院骨一科,云南楚雄675000 [2]唐山市第二医院临床解剖实验室、手外科,河北唐山063000 [3]唐山市第二医院麻醉科,河北唐山063000 [4]楚雄州大姚县平安医院外一科,云南大姚675400 [5]楚雄州元谋县元马镇卫生院外科,云南元谋651300

出　　处：《实用手外科杂志》2020年第3期253-257,共5页Journal of Practical Hand Surgery

摘　　要：目的报道多种不同形状的指动脉逆行岛状皮瓣修复手指中型创面的手术方法和临床疗效。方法2012年4月-2019年1月,收治手指中型创面33例35指,分别采用圆形皮瓣修复5指,椭圆形皮瓣修复15指,长矩形皮瓣修复10指,Y形皮瓣修复3指,圆矩形皮瓣修复2指。结果术后33例35指皮瓣完全成活。出院后26例27指皮瓣获6~77个月的随访,平均15.4个月,7例失访。皮瓣外观良好,质地柔软,两点辨别觉6~10 mm,平均6.5 mm,外观无明显臃肿,无破溃,无明显手指发冷、冻伤病例。采用手指总主动活动度(TAM)法评定手指功能:优23指,良3指,可1指,优良率96.3%。结论异形指动脉逆行岛状皮瓣是修复手指中型创面的一种良好方法和选择,可满足多种复杂创面的修复要求,皮瓣成活率高,功能满意,效果良好。Objective To report the surgrical techniques and clinical results of irregular reversed digital artery island flaps for reconstruction of finger middle-sized soft tissue defects.Methods From April 2012 to January 2019,33 cases of 35 digital sorft tissue defects were involved.Round shape reversed digital artery island flaps were used in 5 fingers,oval shape reversed digital artery island flaps were used in 15 fingers,long rectangle shape reversed digital artery island flaps wrer used in 10 fingers,Y-shape reversed digital artery flaps werw used in 3 fingers,round-rectangle shape reversed digital artery flaps were uesd in 2 fingers.Results Thirty-five flaps in 33 patients survived totally.Twenty-seven flaps of 26 patients were followup for 6 to 77 months(mean 15.4 months).Seven cases were lost to follow-up.The flaps had good appearance and soft texture.The two-point discrimination was 6 to 10 mm with an average of 6.5 mm.There’s no bulkiness,ulceration,digital cold ness and frosbite.The postoperative outcomes were evaluated by the total active movement(TAM)scale.The results were rated as excellent in 23 fingers,good in 3 finger and fair in 1 finger,the overall satisfactory rate was 96.3%.Conclusion Irregular reversed digital artery island flaps is a good satisfactory way and option for reconstruction of digital middle-sized tissue deffects.It can meet the requirement of various complex defects,get high survival rate and good finger function,get good clinical results.

关 键 词：指损伤 中型创面 外科皮瓣 指动脉逆行岛状皮瓣 治疗结果 

分 类 号：R658.2[医药卫生—外科学]