微型游离骨间背动脉穿支皮瓣修复手指皮肤软组织缺损  

The skin and soft tissue defects of the fingers were repaired with the mini free interosseous dorsal artery perforator flap

作　　者：刘海棠 叶锦发 谢沛军 欧治平 曾志超 陈宜梁 LIU Haitang;YE Jinfa;XIE Peijun(Department of Hand Surgery,Huangjiang Hospital,Dongguan,Guangdong,523750,China)

机构地区：[1]东莞黄江医院手足显微外科,广东东莞523750

出　　处：《实用手外科杂志》2021年第2期207-210,共4页Journal of Practical Hand Surgery

摘　　要：目的探究微型游离骨间背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12月-2019年8月,对19例手指皮肤软组织缺损患者行同侧微型游离骨间背动脉穿支皮瓣修复。皮瓣的穿支动脉与指固有动脉或其分支吻合,皮瓣穿支伴行静脉或皮瓣的浅静脉与指背静脉或掌背静脉吻合,皮瓣所携带的皮神经与指背神经或指固有神经接合。供区创面均直接缝合。结果19例皮瓣全部成活,其中3例皮瓣起水疱,经换药后痊愈,余病例均一期愈合。术后随访3~18个月,平均10.9个月,皮瓣颜色、质地接近正常手指皮肤,无臃肿,外观满意。根据中华医学会手外科学会上肢部分功能评定试用标准评定:优15例,良4例。皮瓣两点辨别觉7~12 mm。结论采用微型游离骨间背动脉穿支皮瓣修复手指皮肤软组织缺损,可在同一侧肢体进行,方便麻醉及手术操作,皮瓣肤色、质地、外观满意,切取皮瓣不影响前臂主干血管,血管穿支解剖位置较恒定,对供区损伤小,手术操作简捷,皮瓣设计灵活,特别适于手指小面积皮肤软组织缺损。Objective To investigate the clinical efficacy of mini free interosseous dorsal artery perforator flap on repairing skin and soft tissue defects of fingers.Methods From December 2016 to August 2019,19 patients with skin and soft tissue defects of the fingers were repaired with ipsilateral miniature free interosseous dorsal artery perforator flap(ipsilateral).The perforator artery of the flap was anastomosed with the proper digital artery or its branches,the perforator of the flap was anastomosed with the dorsal digital vein or the superficial vein of the flap,and the cutaneous nerve carried by the flap was anastomosed with the dorsal digital nerve or the proper digital nerve.The wounds in the donor area were sutured directly.Results ALL nineteen cases'l transplanted tisssues survived,3 cases had blistars,after dressing,recovery was obtained other cases had primaryⅠhealing.The skin flap was followed up for 3~18 months,with an average of 10.9 months.According to the trial standard of upper limb partial function assessment of the hand surgery society of Chinese medical association,15 cases were excellent and 4 cases were good.Two-point discrimination of the flap was 7~12 mm.Conclusion The micro free interosseous dorsal artery perforators flap to repair finger skin soft tissue defect,can be done in the same side body,and has convenient anesthesia and surgery operation,the flap skin color,texture,satisfactory appearance are satisfactory,does not affect the forearm main blood vessels,blood vessels in the anatomical position are relatively constant,the damage to the donor area is small.Operation is simple,flap design is flexible,is particularly suitable for finger small area skin and soft tissue defect.

关 键 词：骨间背动脉 穿支皮瓣 手外伤 显微外科手术 

分 类 号：R658.2[医药卫生—外科学]