吻合血管神经的近节指背筋膜带蒂皮瓣修复创伤性指端缺损的疗效观察  

Clinical efficacy of dorsal proximal digital fasciocutaneous pedicle flap with vascular nerves anastomosis in the repair of traumatic fingertip defects

作　　者：胡兴峰[1] 王祥[1] 季亮[1] 梁伟[1] 张博伟 彭阳 皮剑 李青松[1] HU Xingfeng;WANG Xiang;JI Liang;LIANG Wei;ZHANG Bowei;PENG Yang;PI Jian;LI Qingsong(Department of Hand Surgery,The Fourth People's Hospital of Guiyang,Guiyang 550001,China)

机构地区：[1]贵阳市第四人民医院手外科,贵州贵阳550001

出　　处：《中国美容整形外科杂志》2025年第3期160-162,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 吻合血管神经的近节指背筋膜带蒂皮瓣修复创伤性指端缺损的疗效。方法 回顾性分析自2020年3月至2023年2月,贵阳市第四人民医院手外科收治的35例创伤性指端缺损患者临床资料,急诊采用吻合血管神经的近节指背筋膜带蒂皮瓣修复。结果 35例创伤性指端缺损患者,皮瓣均成活良好,皮瓣均一期愈合,未出现皮瓣坏死,其中4例术后出现皮瓣肿胀伴有张力性水泡,经抽液部分拆线等减张处理后愈合,供区植皮均成活。术后随访18个月,皮瓣外观饱满无臃肿,两点辨别觉5~10 mm。根据中华医学会手功能评定试用标准进行功能评定:优28例,良7例,优良率为100%。结论 吻合血管神经的近节指背筋膜带蒂皮瓣修复创伤性指端缺损的临床操作简单,术后指端外形和功能得到良好恢复,便于临床推广应用。Objective To analyze the clinical efficacy of dorsal proximal digital fasciocutaneous pedicle flap with vascular nerves anastomosis in repair of traumatic fingertip defects. Methods From March 2020 to February 2023, Department of Hand Surgery, The Fourth People's Hospital of Guiyang admitted to the clinical data of 35 cases with traumatic fingertip defects were retrospectively analyzed.All patients were repaired by dorsal proximal digital fasciocutaneous pedicle flap with vascular nerves anastomosis. Results Thirty-five cases of transplanted flaps and dorsal digital grafts survived. Only four cases of flaps developed blisters after operation. After the blisters were drawn, the color of flaps was ruddy and the wounds healed in one stage. The longest follow-up was 18 months, the appearance and texture of the flap were good. No obvious pigmentation and swelling of the flaps were found. The sensation of flap recovered well. The two-point discrimination was 5 to 10 mm. According to the trial criteria for hand function assessment of the Chinese Medical Association,28 cases were rated as excellent, 7 cases as good, and the excellent and good rate was 100%. Conclusion The application of dorsal proximal digital fasciocutaneous pedicle flap with vascular nerves anastomosis in repair of traumatic fingertip defects can obtain satisfactory clinical efficacy.

关 键 词：指背筋膜带蒂皮瓣 指端缺损 吻合血管神经 软组织重建 

分 类 号：R658.2[医药卫生—外科学]