“途中阻断法”改良动脉化静脉皮瓣在手指软组织缺损修复中的应用  

Application of modified arterialized venous flap with intraoperative blocking method to repair digital soft tissue defect

作　　者：余丰年 肖芬 王文松 魏新旺 曾政伦 刘亚平 YU Fengnian;XIAO Fen;WANG Wensong(Department of Orthopedics,Guzhen People's Hospital of Zhongshan City,Guangdong,528421,China)

机构地区：[1]中山市古镇人民医院骨科,广东中山528421 [2]四川现代医院手外科,四川成都610045

出　　处：《实用手外科杂志》2020年第4期459-461,464,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨"途中阻断法"改良动脉化静脉皮瓣对手指皮肤软组织缺损修复的效果。方法选取2017年7月-2019年7月收治的20例手外伤患者,均为指端及(或)指背皮肤软组织缺损,缺损面积:1.5 cm×1.5 cm^3.5 cm×4.5 cm。取前臂游离双干型静脉皮瓣,逆血管瓣膜设计,将准备动脉化的静脉在皮瓣内走行至1/2处,结扎阻断,并确认其与回流静脉之间无直接交通支。灌注与回流血管比例为1∶1。结果所有皮瓣均顺利成活,仅5例动脉化血管走行的周围区域出现小面积细小水疱,其余15例皮瓣色泽红润,无水疱形成。术后半年手指外观满意,皮瓣质地与周围皮肤相仿。结论"途中阻断法"改良动脉化静脉皮瓣,有助于改善动脉化静脉皮瓣的成活质量。Objective To investigate the effect of modified arterialized venous flap with intraoperative blocking method,on repairing soft tissue defect of fingers.Methods Twenty cases of hand trauma,fingertip and/or dorsal defect selected from July 2017 to July 2019 were observed,the defect area was 1.5 cm×1.5 cm^3.5 cm×4.5 cm.The free double branch venous flap which was devised reversing vascular valve,was harvested.In the flap,the vein intended to be arterialized was blocked at the half path,and make sure there were no other communicating branch connected with the reflux vein,the ratio of perfusion and return was about 1:1.Results All flaps survived,only 5 cases had small vesicles in the area near the arterialized vessels,while the others were ruddy and had no vesicles.At the 6 th months’followup,the appearance of the fingers were satisfactory,and the flap texture was similar to that of the surrounding skin.Static two-point discrimination was 10~16 mm.Conclusion Intraoperative blocking was a useful way to promote the quality of arterialized venous flaps.

关 键 词：动脉化静脉皮瓣 手术改良 手指修复 软组织缺损 

分 类 号：R658.2[医药卫生—外科学]