基于指动脉背侧支供血的蝶形皮瓣与螺旋桨皮瓣修复手指掌侧创面疗效的对比研究  

A comparative study of the curative effects between butterfly-shaped flap and propeller flap based on the dorsal branch of digital artery in repairing the wound in volar aspect of finger

作　　者：孙旭 殷宗琦 郑捷新[1] 窦懿[1] 张勤[1] 付强 张文龙 易磊 Sun Xu;Yin Zongqi;Zheng Jiexin;Dou Yi;Zhang Qin;Fu Qiang;Zhang Wenlong;Yi Lei(Department of Burn and Plastic Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Orthopedics,General Hospital of PLA Central Theater Command,Wuhan 430072,China;Department of Hand Surgery,the People's Hospital of Tianjin,Tianjin 300121,China)

机构地区：[1]上海交通大学医学院附属瑞金医院灼伤整形科,上海200025 [2]解放军中部战区总医院骨科,武汉430072 [3]天津市人民医院手外科,天津300121

出　　处：《中华烧伤与创面修复杂志》2023年第6期552-557,共6页Chinese Journal of Burns And Wounds

摘　　要：目的对比基于指动脉背侧支供血的蝶形皮瓣(以下简称蝶形皮瓣)与基于指动脉背侧支供血的螺旋桨皮瓣(以下简称螺旋桨皮瓣)修复手指掌侧创面的疗效。方法采用回顾性队列研究方法。2018年8月—2022年4月,上海交通大学医学院附属瑞金医院收治16例、解放军中部战区总医院收治7例符合入选标准的手指掌侧创面患者,其中男14例、女9例,年龄25~64岁,清创或皮肤良性肿瘤切除术后创面面积为0.5 cm×0.5 cm~1.5 cm×1.5 cm。按照创面修复时皮瓣蒂部旋转轴向,将患者分为蝶形皮瓣组(8例)和螺旋桨皮瓣组(15例),分别采用蝶形皮瓣(面积为0.5 cm×0.5 cm~1.5 cm×1.3 cm)和螺旋桨皮瓣(面积为0.7 cm×0.5 cm~1.5 cm×1.5 cm)修复创面。螺旋桨皮瓣组供区创面取手腕掌侧或腹股沟处全厚皮片游离移植修复。记录2组患者手术时间,术后并发症、皮瓣成活情况和创面愈合时间。对数据行独立样本t检验、Mann-Whitney U检验、Fisher确切概率法检验。结果蝶形皮瓣组患者手术时间、术后创面愈合时间[(43±9)min、(13.1±0.8)d]均明显短于螺旋桨皮瓣组[(87±16)min、(16.7±4.6)d,t值分别为-7.03、-2.86,P<0.05]。2组患者术后皮瓣成活、并发症情况均相近(P>0.05)。结论对于手指掌侧创面的修复,蝶形皮瓣与传统螺旋桨皮瓣相比更具优势;蝶形皮瓣手术时间短,术后恢复快,值得临床推广。Objective To compare the curative effects of butterfly-shaped flap based on the dorsal branch of digital artery(hereinafter referred to as butterfly-shaped flap)and propeller flap based on the dorsal branch of digital artery(hereinafter referred to as propeller flap)in repairing the wound in volar aspect of finger.Methods A retrospective cohort study was conducted.From August 2018 to April 2022,16 patients with finger palmar wounds admitted to Ruijin Hospital of Shanghai Jiao Tong University School of Medicine and 7 patients with finger palmar wounds admitted to General Hospital of PLA Central Theater Command met the inclusion criteria,including 14 males and 9 females,aged 25 to 64 years.After debridement or resection of skin benign tumor,the wounds ranged from 0.5 cm×0.5 cm to 1.5 cm×1.5 cm.According to the different rotation axes of flap pedicle during wound repair,the patients were divided into butterfly-shaped flap group(8 cases)and propeller flap group(15 cases),and their wounds were repaired by butterfly-shaped flap(with area of 0.5 cm×0.5 cm-1.5 cm×1.3 cm)or propeller flap(with area of 0.7 cm×0.5 cm-1.5 cm×1.5 cm),respectively.In propeller flap group,wounds in the donor sites were repaired by full-thickness skin grafts taken from the palms of wrists or the groin.The surgical time,postoperative complications,flap survival,and wound healing time of patients in the two groups were recorded.Data were statistically analyzed with independent sample t test,Mann Whitney U test,or Fisher's exact probability test.Results The surgical time and postoperative wound healing time of patients in butterfly-shaped flap group((43±9)min and(13.1±0.8)d,respectively)were both significantly shorter than those in propeller flap group((87±16)min and(16.7±4.6)d,respectively,with t values of-7.03 and-2.86,respectively,P<0.05).The postoperative flap survival and complications of patients between the two groups were both similar(P>0.05).Conclusions For repairing the wound in volar aspect of finger,the butterfly-shaped flap h

关 键 词：外科皮瓣 指 修复外科手术 蝶形皮瓣 螺旋桨皮瓣 

分 类 号：R658.2[医药卫生—外科学]