第2掌背动脉供血的示指近节背侧岛状皮瓣修复拇指软组织缺损  

Index finger porximal dosal island flap supplied by the second dosal metacarpal artery in repair of the soft tissue defect of thumb

作　　者：杨焕友[1] 王斌[1] 李瑞国[1] 黄蕾 王伟[1] YANG Huanyou;WANG Bin;LI Ruiguo;HUANG Lei;WANG Wei(Department of Hand Surgery,The Second Hospital of Tangshan,Tangshan,Hebei Province 063000,China)

机构地区：[1]唐山市第二医院手外科,河北唐山063000

出　　处：《中华显微外科杂志》2021年第3期276-278,共3页Chinese Journal of Microsurgery

基　　金：河北省医学科学研究课题计划项目(20191519)。

摘　　要：目的探讨第2掌背动脉(SDMA)供血的示指近节背侧岛状皮瓣修复拇指软组织缺损方法及疗效。方法2015年8月至2017年12月,共收治12例拇指软组织缺损患者,创面面积大小为2.0 cm×2.4 cm-5.5 cm×3.0 cm,采用SDMA供血的示指近节背侧岛状皮瓣进行修复,皮瓣切取面积为2.2 cm×2.6 cm-6.0 cm×3.3cm,供区取伤肢前臂中厚皮片游离植皮。所有患者术后定期进行门诊随访,观察皮瓣外观、皮瓣质地和感觉恢复及供区情况。结果本组12例皮瓣全部成活,供区及受区伤口愈合良好。术后随访5-16个月,平均8.8个月,皮瓣外观和感觉功能良好,质地柔软,皮瓣供区及手背切口未见瘢痕挛缩,无疼痛及关节活动受限。拇指功能按中华医学会手外科学会上肢部分功能评定试用标准评价:优11例,良1例。结论SDMA供血的示指近节背侧岛状皮瓣,具有手术操作简单、供血恒定、血管蒂旋转角度大、变异率低等优点,是修复拇指软组织缺损的较好方法。Objective To investigate the method and outcome of reconstruction of thumb soft tissue defect by index finger proximal dorsal island flap supplied by the second dorsal metacarpal artery(SDMA).Methods From August,2015 to December,2017,12 cases of thumb soft tissue defect were treated by index finger proximal dorsal island flap supplied by SDMA.The site of defect ranged from 2.0 cm×2.4 cm to 5.5 cm×3.0 cm,and the flap area ranged from 2.2 cm×2.6 cm to 6.0 cm×3.3 cm.The donor site was repaired by split-thickness skin graft from the forearm of the injured limb.All patients received regular outpatient follow-up after surgery.The appearance,texture,sensory recovery and donor site of the flap were observed.Results All the 12 flaps had 5-16(8.8 in average)months follow-up and survived,the donor site and wounds healed in primary stage.The appearance,sensory and function of the flaps were good.There were no scar contracture on the donor sites,and no pain and limitation of motion in the joints.At the last follow-up,according to the Criteria for Function Assessment of Upper Limbs by the Branch of Hand Surgery of Chinese Medicine Association,the thumb functions were excellent in 11 cases and good in 1 case.Conclusion Index finger proximal dorsal island flap supplied by SDMA is easy to operate,and has constant blood supply,improved rotation angle of the flap vessel base.It is a good method to repair the soft tissue defect of thumb.

关 键 词：第2掌背动脉 岛状皮瓣 示指 拇指 软组织缺损 修复 

分 类 号：R658.2[医药卫生—外科学]