桡动脉掌浅支皮瓣在伴指固有动脉缺损的手指创面修复中的应用  

Application of the superficial palmar branch of the radial artery flap for repairing finger wounds with proper digital artery defect

作　　者：孙洋[1] 方杰 陈江华[1] 刘英杰[1] 张文龙 SUN Yang;FANG Jie;CHEN Jiang-hua;LIU Ying-jie;ZHANG Wen-long(Dept of Hand Surgery,the Second Hospital of Tangshan City,Tangshan,Hebei 063000,China;Dept of Hand Surgery,Tianjin Union Medical Center,Tianjin 300121,China)

机构地区：[1]唐山市第二医院手外科,河北唐山063000 [2]徐州仁慈医院手外科,江苏徐州221004 [3]天津市人民医院手外科,天津300121

出　　处：《临床骨科杂志》2023年第5期664-668,共5页Journal of Clinical Orthopaedics

基　　金：河北省卫健委医学科学研究课题计划项目(编号:20201462);江苏省徐州市卫健委2021年度青年医学科技创新项目(编号:XWKYHT20210550)。

摘　　要：目的探讨桡动脉掌浅支皮瓣在伴指固有动脉缺损的手指创面修复中的应用效果。方法采用血流桥接技术桡动脉掌浅支皮瓣修复21例伴有指固有动脉缺损的手指创面。采用中华医学会手外科学会上肢部分功能评定试用标准评价指关节功能恢复情况。依据张浩等制定的疗效满意度评分表评价术后疗效。结果患者均获得随访,时间7~25个月。术后供区切口及受区伤口均一期愈合,无感染发生。皮瓣均顺利成活,无动、静脉血管危象及坏死,伤指无血供障碍等并发症发生。20例皮瓣外观无明显臃肿,1例术后9个月随访时皮瓣稍显臃肿。末次随访时,患者疗效满意度5~10分,均为满意;皮瓣两点辨别觉为6~14 mm;采用中华医学会手外科学会上肢部分功能评定试用标准评价指关节功能:优18例,良3例。结论采用桡动脉掌浅支皮瓣可一次手术完成指缺损创面和指固有动脉缺损的修复,且皮瓣薄,解剖操作简单,疗效满意。Objective To investigate the application effect of the superficial palmar branch of radial artery flap in repairing finger wounds with proper digital artery defect.Methods The superficial palmar branch of radial artery flap was used to repair 21 cases of finger wounds with proper digital artery defect using flow-through bridging technique.The finger joint function recovery was evaluated by the trial standard for the evaluation of the upper limb function of the Hand Surgery Society of the Chinese Medical Association.The postoperative efficacy was evaluated according to the efficacy satisfaction scale formulated by Zhang Hao et al.Results All patients were followed up for 7~25 months.All incisions at the donor site and the recipient site healed primarily,without infection.All flaps survived without arteriovenous vascular crisis and necrosis,and no complications such as blood supply disorder occurred.Twenty cases of flaps had no obvious bloated appearance,and 1 case was slightly bloated at 9 months after operation.At last follow-up,the patients′satisfaction scores was 5~10 points,they were all satisfied and the two-point discrimination of the flaps was 6~14 mm.According to the upper limb function evaluation standard of the Hand Surgery Society of the Chinese Medical Association,the finger joint function was excellent in 18 cases and good in 3 cases.Conclusions The superficial palmar branch of radial artery flap can be used to repair the finger defect wound and the proper digital artery defect in one operation.The flap is thin,the anatomical operation is simple,and the effect is satisfactory.

关 键 词：血流桥接技术 桡动脉掌浅支 游离皮瓣 指损伤 

分 类 号：R622.1[医药卫生—整形外科] R658.2[医药卫生—外科学]