第1掌背动脉皮瓣在拇示指皮肤缺损中的应用  

Application of the first dorsal metacarpal artery flap in the treatment of skin defects of the thumb and index finger

作　　者：赵洋[1] 曾文超[1] 曲兆鹏 ZHAO Yang;ZENG Wenchao;QU Zhaopeng(Department of Foot and Ankle Surgery,Jining No.1 People's Hospital,Shandong,Jining,272000,China)

机构地区：[1]济宁市第一人民医院手外科足踝外科,山东济宁272000

出　　处：《实用手外科杂志》2024年第4期463-465,共3页Journal of Practical Hand Surgery

摘　　要：目的总结第1掌背动脉皮瓣在治疗拇指指间关节及示指中远节平面皮肤缺损中的应用经验。方法2016年7月-2023年7月共收治拇指指间关节皮肤缺损患者13例,示指中远节平面皮肤缺损患者17例。均采用第1掌背动脉皮瓣修复。软组织缺损面积:1.5 cm×2.3 cm~2.5 cm×3.2 cm,皮瓣切取面积:2.0 cm×2.6 cm~2.8 cm×3.5 cm。结果所有皮瓣均顺利成活。术后采用门诊或微信随访,随访时间6~12个月,平均7.2个月。末次随访时,均有不同程度色素沉着,轻度臃肿及瘢痕。运动功能恢复按照美国手外科学会推荐的TAM系统评定方法:优23指,良7指,优良率为100%;感觉功能恢复按照英国医学研究会评定标准评定:3例S4,14例S3+,3例S3。结论第1掌背动脉皮瓣可根据需要顺行或逆行切取,其切取方便,成活率高,术后感觉及运动功能恢复好,是修复累及拇指指间关节及示指中远节平面软组织缺损的良好方法。Objective To summarize the experience of the first dorsal metacarpal artery flap in the treatment of skin defects at the interphalangeal joint of the thumb and the middle and distal level of the index finger.Methods From July 2016 to July 2023,13 patients with skin defects involving the interphalangeal joint of the thumb and 17 patients with shin defects at the middle and distal level of the index finger were treated in our hospital.The first dorsal metacarpal artery flap was used for repair under brachial plexus anesthesia.The size of soft tissue defect ranged from 1.5 cm×2.3 cm to 2.5 cm×3.2 cm,and the size of flap ranged from 2.0 cm×2.6 cm to 2.8 cm×3.5 cm.Results All the flaps survived successfully.The patients were followed up by outpatient examination or wechat,and the follow-up time was 6 months to 12 months,with an average of 7.2 months.At the last follow-up,all patients had different degrees of pigmentation,mild bloating and scar.The motor recovery was rated as excellent in 23 fingers and good in 7 fingers according to the TAM system recommended by the American Association of Hand Surgery,with an excellent and good rate of 100%.The sensory recovery was rated as S4 in 3 cases,S3+in 14 cases,and S3 in 3 cases according to the British Medical Research Council.Conclusion The first dorsal metacarpal artery flap can be cut antegrade or retrograde according to the need.It is easy to harvest,with a high survival rate and good postoperative sensory and motor recovery.It is a good method to repair the soft tissue defects involving the thumb interphalangeal joint and the middle and distal segment of the index finger.

关 键 词：软组织缺损 第1掌背动脉皮瓣 顺行 逆行 

分 类 号：R658.2[医药卫生—外科学]