改良切口切取以甲缘静脉-趾背静脉回流的趾腓侧皮瓣修复手指指腹创面  

Repair of finger pulp defect using great toe fibular flap with reflux of marginal nail vein and dorsal toe vein by modified incision

作　　者：刘会军 杨勇 谢山洪 蒋志勋 吕硕洋 李亚杰 Liu Huijun;Yang Yong;Xie Shanhong;Jiang Zhixun;Lyu Shuoyang;Li Yajie(Department of Hand and Foot Surgery,Beijing Dawang Road Emergency Hospital,Bejing 100020,China;Department of Hand Surgery,Beijing Jishuitan Hospital of the Capital University of Medical Sciences,Beijing 100035,China)

机构地区：[1]北京大望路急诊抢救医院手足外科,北京100020 [2]首都医科大学附属北京积水潭医院手外科,北京100035

出　　处：《中华手外科杂志》2024年第5期401-404,共4页Chinese Journal of Hand Surgery

摘　　要：目的 探讨利用改良切口切取以甲缘静脉-趾背静脉回流的趾腓侧皮瓣修复手指指腹创面的应用及临床疗效.方法 自2019年6月至2022年6月,我科设计增加趾趾背辅助切口和趾腓侧瓣近端三角形皮瓣的改良方式,显露和游离甲缘静脉-趾背静脉回流系统.本组切取趾腓侧皮瓣12例,修复拇指6例、中指5例、环指1例.切取皮瓣面积1.0 cm×1.5 cm~3.0 cm×3.5 cm.结果 术后12例皮瓣顺利存活,伤口 Ⅰ期愈合.术后随访6~12个月,平均8.2个月.皮瓣外形好,指腹饱满,有螺纹,质地柔软耐磨,两点分辨觉5~8 mm.结论 利用改良切口切取以甲缘静脉-趾背静脉为回流系统的趾腓侧皮瓣,静脉显露充分,降低了静脉游离难度.修复手指指腹创面临床效果良好,皮瓣成活率高.ObjectiveTo explore the application and clinical efficacy of great toe fibular flap with reflux of marginal nail vein and dorsal toe vein to repair the finger pulp defect by modified incision.Methods From June 2019 to June 2022,we designed an modified method of adding an auxiliary incision on the back of the toes and a triangular flap at the proximal end of great toe fibular flap,exposing and freeing the marginal nail vein-dorsal vein reflux system.In this group,12 cases of great toe fibular flap were removed,and 6 cases of thumbs,5 cases of middle fingers,and 1 case of ring fingers were repaired.The skin flap area ranged from 1.0 cm×1.5 cm to 3.0 cm×3.5 cm.Results After the operation,the flap survived successfully in twelve cases and the wound achieved primary healing.The patients were follow-up for 6 to 12 months with an average of 8.2 months.The skin flap has a good appearance,a full finger belly,threaded,soft and wear-resistant texture,and a two-point discriminationof 5.0 to 8.O mm.Conclusion The great toe fibular flap with the reflux of marginal nail vein and dorsal toe vein cut by modified incision could repair the finger pulp defect.The veins were fully exposed,reducing the difficulty of vein mobilization.The clinical efficacy of repairing fingertip wounds is good,and the survival rate of skin flaps is high.

关 键 词：外科皮瓣 治疗结果 甲缘静脉 趾背静脉 

分 类 号：R658.2[医药卫生—外科学]