足底内侧静脉皮瓣修复甲瓣供区的临床应用  

Clinical application of medial plantar venous flap for repairing great toenail flap donor site

作　　者：邹时雨 王克列 肖春生 张宜之 陈品琨 代力臻 杨延军 张子清 Zou Shiyu;Wang Kelie;Xiao Chunsheng;Zhang Yizhi;Chen Pinkun;Dai Lizhen;Yang Yanjun;Zhang Ziqing(Department of Hand Surgery,Longgang Orthopedic Hospital of Shenzhen,Shenzhen 518116,China)

机构地区：[1]深圳市龙岗区骨科医院手外科,深圳518116

出　　处：《中华整形外科杂志》2023年第5期496-501,共6页Chinese Journal of Plastic Surgery

基　　金：深圳市龙岗区科技发展专项资金(LGKCYLWS2019000843,LGKCYLWS2020113)。

摘　　要：目的探讨应用足底内侧静脉皮瓣修复甲瓣供区的临床效果及可行性。方法回顾性分析2020年1月至2021年6月深圳市龙岗区骨科医院应用足底内侧静脉皮瓣修复甲瓣或部分甲瓣移植再造手指供区的患者临床资料。术中足底内侧静脉皮瓣供区采用游离全厚皮片移植修复。术后观察皮瓣成活情况并随访皮瓣外观、感觉恢复及并发症发生情况,根据Maryland足功能评定标准评价足部功能。结果共纳入6例患者,男5例,女1例,年龄14~28岁,平均22岁;甲瓣创面面积2.2cm×3.7cm~5.5cm×7.0cm,足底内侧静脉皮瓣切取面积为2.5cm×3.8cm~5.5cm×7.1cm。术后6例皮瓣均成活良好,2例出现水疱。术后随访3~18个月,平均9个月,所有皮瓣外观均无臃肿,颜色、质地佳,无破溃,疼痛,两点辨距觉7~10mm,第2、3供区隐蔽。根据Maryland足功能评定标准,6例均评为优。结论应用足底内侧静脉皮瓣修复甲瓣供区,具有供区隐蔽、皮瓣不臃肿、质地好、成活率高、感觉恢复可的优点,是一种有效的修复方法。Objective To explore the clinical efficacy and feasibility of applying a medial plantar vein flap to repair the great toenail flap donor site.Methods A retrospective analysis was performed on the clinical data of patients who underwent great toenail flap or partial great toenail flap transplantation for finger reconstruction from January 2020 to June 2021 in Longgang Orthopedic Hospital of Shenzhen.During the operation,the donor site of the great toenail flap was repaired with medial plantar venous flaps,and the donor site of the medial plantar venous flaps was repaired with a free full-thickness skin graft.The survival of the flap was observed and the appearance,sensation,and complications of the flap were followed up.The foot function was evaluated by the Maryland foot function evaluation standard.Results A total of 6 cases were enrolled,including 5 males and 1 female with an average of 22 years,ranged from 14-28 years old.The wound area of the great toenail flap was 2.2 cm×3.7 cm-5.5 cm×7.0 cm,and the skin flap was 2.5 cm×3.8 cm-5.5 cm×7.1 cm.All flaps survived.2 cases developed tension blisters.All patients were followed up for 3-18 months,with an average of 9 months.And all flaps had no swollen appearance,good color,texture,and no ulcers or pain.Two-point discrimination was 7-10 mm,and the second/third donor area was concealed.According to the Maryland foot function evaluation standard,all 6 cases were rated as excellent.Conclusion The application of the medial plantar vein flap to repair the donor area of the great toenail flap is an effective repair method.The donor area is concealed,the flap is not bloated,the texture is good,the survival rate is high,and the sensation recovered satisfactory.

关 键 词：外科皮瓣 足底内侧皮瓣 静脉皮瓣 甲瓣供区 创面修复 

分 类 号：R658.3[医药卫生—外科学]