游离纯静脉皮瓣在复杂断指再植中的应用  

Treatment of the free simple venous flap for replantation of severed amputated fingers

作　　者：吴穷 皮建波 吴茂标 黄东 WU Qiong;PI Jianbo;WU Maobiao(Department Five of Hand Microsurgery,Heping Orthopaedic Hospital of Guangzhou City,Guangzhou,Guangdong,510320,China)

机构地区：[1]广州和平骨科医院手五区,广东广州510320

出　　处：《实用手外科杂志》2024年第4期446-448,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨游离纯静脉皮瓣在复杂断指再植中的临床疗效。方法自2020年3月-2024年1月,采用前臂掌侧静脉皮瓣桥接修复合并背侧皮肤软组织缺损的复杂断指共10例13指,断指背侧皮肤软组织缺损面积:1.0 cm×1.5 cm~5.0 cm×6.0 cm。结果术后10例13指皮瓣均成活,再植术后无动脉危象发生,其中有3例3指术后72 h出现皮瓣瘀紫、水疱,经拆线、针刺抽吸水疱液等对症处理,皮瓣成活。术后随访3~12个月,平均7个月。所有断指均成活,皮瓣血运与质地优良,无明显萎缩及臃肿,3例皮瓣出现色素沉着,其余皮瓣颜色正常。按中华医学会手外科学会断指再植术后功能评定试用标准:优7指,良3指,差3指,优良率为76.9%。结论纯静脉皮瓣一次性修复复杂断指背侧血管与皮肤缺损,适用于手背及手指中近节创面,创伤小,取材方便,操作简便,临床疗效可靠,值得临床推广。Objective To investigate the clinical outcomes and experience of using free simple venous flap for replanting complex amputated finger.Methods The forearm volar vein flap was used in the patients that need reconstruction and replantation of the severed finger with complex dorsal skin and vascular defect,from 2020.3-2024.1,summarized 13 cases.Results All the flaps survived after transplantation.The patients were followed up for 3-12 months,with an average of 7 months.The blood supply of the flaps were good and the flaps were soft,the appearance of the flaps were satisfactory.According to the trial standard of functonal evaluation after finger replantation by Chinese Society of Hand Surgery:7 was excellent,3 was good,3 was poor,the excellent ang good rate was 76.9%.Conclusion The simple flap can repair the complex severed amputated finger with the dorsal skin and vascular defect,and have advantages of less damage,convenience.The clinical effect is reliable.It is a technology worthy of clinical promotion.

关 键 词：纯静脉皮瓣 复杂断指再植 背侧皮肤血管缺损 显微外科 

分 类 号：R658.1[医药卫生—外科学]