一侧血管神经束为蒂的旋转皮瓣修复手指远节软组织缺损  

Rotation flap pedicled with vascular nerve bundle in the repair of fingertip soft tissue defect

作　　者：钟贤 戴平 徐晓晨 陆辉 张建超 ZHONG Xian;DAI Ping;XU Xiaochen;LU Hui;ZHANG Jianchao(Department of Plastic Surgery,Changshu Hospital Affiliated to Soochow University,Changshu 215500,China)

机构地区：[1]苏州大学附属常熟医院(常熟市第一人民医院)整形-手足外科,江苏常熟215500

出　　处：《中国美容整形外科杂志》2022年第11期693-695,I0009,共4页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：常熟市卫生健康委员会科技计划项目(csws2020005)。

摘　　要：目的观察一侧血管神经束为蒂的旋转皮瓣修复手指远节软组织缺损的临床疗效。方法自2019年8月至2020年8月,苏州大学附属常熟医院(常熟市第一人民医院)整形-手足外科采用一侧血管神经束为蒂的旋转皮瓣修复15例(15指)手指远节软组织缺损患者,创面面积1.5 cm×2.0 cm~2.0 cm×2.5 cm。皮瓣切取面积1.6 cm×2.1 cm~2.1 cm×2.6 cm。结果15例皮瓣术后皮瓣无血运危象发生,全部一期成活。供区及残余创面移植皮片均成活良好。获随访6~18个月,皮瓣血运颜色红润,质地柔软、外形美观逼真,无明显瘢痕挛缩,无色素沉着,手指活动功能良好。皮瓣感觉恢复良好,无寒冷性刺痛,两点辨别觉为3~8 mm。手指远指间关节活动和持捏功能正常。按中华医学会手外科学会上肢部分功能评定试用标准评定,所有患者功能均达优。结论一侧血管神经束为蒂的旋转皮瓣修复手指远节软组织缺损手术操作安全简单,血供充足,皮瓣外形逼真,活动及感觉功能恢复良好,对供区影响较小。Objective To observe the clinical efficacy of rotation flap pedicled with vascular nerve bundle in the repair of fingertip soft tissue defect.Methods From August 2019 to August 2020,15 patients with fingertip soft tissue defect(15 fingers)were repaired by rotation flap pedicled with vascular nerve bundle.The area of defect was from 1.5 cm×2.0 cm to 2.0 cm×2.5 cm.The area of flap was from 1.6 cm×2.1 cm to 2.1 cm×2.6 cm.Results All flaps survived and no vascular crisis occurred.The donor site recovered well.All patients were followed-up for 6 to 18 months.The blood supply of flap was good,the texture was soft,the appearance was natural and no scar contracture or pigmentation occurred.The finger movement recovered.The sensory recovery of flap was good,without cold sensation or tingling.The two-point discrimination was 3 to 8 mm.The distal interphalangeal joint movement and pinching function were normal.According to the upper limb function evaluation standard of Chinese Medical Association,finger movement in all patients were optimal.Conclusion Rotation flap pedicled with vascular nerve bundle for the repair of fingertip soft tissue defect is safe and simple,the blood supply is adequate,the movement and sensory function recovered well and the influence on donor site is small.

关 键 词：带蒂皮瓣 旋转皮瓣 软组织缺损 血管神经束 

分 类 号：R658.2[医药卫生—外科学]