指固有动脉背侧支血管链蒂逆行岛状皮瓣修复指端缺损的近期疗效分析及治疗体会  

The short-term efficacy and treatment experience of reverse island flaps based on vascular chain between the dorsal branches of the digital artery for repairing the defects of finger tips

作　　者：郑江钒[1] 谷爱奇[1] 闵祥辉[1] 王煜[1] ZHENG Jiang-fan;GU Ai-qi;MIN Xiang-hui(Department of Emergency Trauma,Zhongshan Hospital of Xiamen University,Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院急诊创伤外科,361004

出　　处：《中国实用医药》2024年第4期60-63,共4页China Practical Medicine

摘　　要：目的分析指固有动脉背侧支血管链蒂逆行岛状皮瓣修复指端缺损的近期疗效,并总结治疗体会。方法回顾性分析21例(21指)指端缺损患者的临床资料,患者均行指固有动脉背侧支血管链蒂逆行岛状皮瓣修复。随访评估患者的主观满意度、皮瓣感觉恢复情况、患指活动功能。结果术后19例患者皮瓣完全成活并顺利拆线,1例因术后私自吸烟致皮瓣严重发绀延迟愈合,1例因术后私自开空调温度过低致皮瓣部分坏死。21例患者中共19例获得随访,随访时间3~18个月,平均(8.9±4.6)个月。获得随访患者中,患者的主观满意度:很满意16例(84.2%)、比较满意3例(15.8%),无不满意病例。皮瓣感觉恢复情况:S415例(78.9%),S3+3例(15.8%),S31例(5.3%)。患指活动功能:优16例(84.2%),良3例(15.8%)。结论指固有动脉背侧支血管链蒂逆行岛状皮瓣修复指端缺损外形功能满意,优势明显,术后积极处理和密切护理对于术后良好疗效亦至关重要。Objective To analyze the short-term efficacy of reverse island flaps based on vascular chain between the dorsal branches of the digital artery for repairing the defects of finger tips,and review the treatment experiment.Methods Retrospective analysis was made on clinical data of 21 patients(21 fingers)with finger tip defect.All patients were repaired by reverse island flaps based on vascular chain between the dorsal branches of the digital artery.The subjective satisfactions,sensory of flap,activity function of the affected finger were assessed during follow-up.Results 19 flaps were fully viable and the sutures were removed successfully,1 case delayed in healing due to severe cyanosis caused by postoperative smoking,another 1 case got partial necrosis because of opening air conditioning,which leading to low temperature.19 of 21cases were followed up ranging from 3 to 18 months,with an average of(8.9±4.6)months.In the follow-up cases,the subjective satisfaction of patients:very satisfied in 16 cases(84.2%),relatively satisfied in 3 cases(15.8%),and there were no unsatisfied cases.Flap sensory recovery:S4 in 15 cases(78.9%),S3+in 3 cases(15.8%),S3 in 1 case(5.3%).Activity function of the affected finger:excellent in 16 cases(84.2%),good in 3 cases(15.8%).Conclusion Reverse island flaps based on vascular chain between the dorsal branches of the digital artery for repairing defect of finger tip can reach good texture and contour,and has a clear advantage.But dealing with complications actively and the close nursing postoperatively are remain essential for a good clinical outcome.

关 键 词：岛状皮瓣 指固有动脉背侧支 指端缺损 手外伤 创面修复 

分 类 号：R658.2[医药卫生—外科学]