目的 总结以近节指动脉背侧支为蒂的掌指背皮瓣修复手指中远节软组织缺损疗效。
方法 2011年4月-2014年4月,收治10例(13指)手指中远节皮肤软组织缺损患者。男7例,女3例;年龄12~56岁,平均35岁。致伤原因:压砸伤6例,挤压伤2例,热压伤1例,切割伤1例。损伤指别:示指8例,中指4例,环指1例。手指缺损面积2.5 cm×1.5 cm~6.0 cm×3.5 cm。设计以近节指动脉背侧支为蒂的掌指背逆行岛状皮瓣修复创面,皮瓣切取范围3.0 cm×2.0 cm~7.5 cm×4.5 cm。供区直接缝合或游离植皮修复。
结果 术后2~3 d,3例(3指)皮瓣出现肿胀、张力性水疱,经对症处理成活;其余皮瓣及供区植皮均成活,创面Ⅰ期愈合。患者均获随访,随访时间8~18个月,平均14个月。皮瓣质地、弹性好,外观饱满。术后8个月,皮瓣两点辨别觉8~10 mm,平均8.9 mm;手功能按中华医学会手外科学会上肢部分功能评定试用标准评定:优6例,良3例,可1例。
结论 采用以近节指动脉背侧支为蒂的掌指背逆行岛状皮瓣修复手指中远节软组织缺损,符合皮瓣就近转移的原则,手术切取简便,疗效肯定。
Citation:
叶国强, 刘治军, 郑灿镔, 张迅超. 近节指动脉背侧支为蒂的掌指背皮瓣修复手指中远节软组织缺损. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(7): 917-918. doi: 10.7507/1002-1892.20150196
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
1. |
Friedrich JB,Katolik LI,Vedder NB.Soft tissue reconstruction of the hand.J Hand Surg (Am),2009,34(6):1148-1155.
|
2. |
姚群,芮永军,许亚军,等.不同远端蒂逆行掌背皮瓣修复手指软组织缺损.中华手外科杂志,2012,28(3):140-142.
|
3. |
孙雪峰,史勇,简争光,等.远端蒂掌指背皮神经营养血管皮瓣修复手指皮肤缺损.临床和实验医学杂志,2011,10(24):1937-1939.
|
4. |
周晓,芮永军,寿奎水,等.近节掌指背皮瓣修复指根部岛状皮瓣供区的临床应用.中华手外科杂志,2012,28(4):221-223.
|
5. |
Chen CC,Chang HH,Tang YB,et al.Combined first dorsal metacarpal artery flap and dorsal transposition flap for correction of extensive first web space contracture:a case report and literature review.Ann Plast Surg,2011,67(4):364-366.
|
6. |
Sebastin SJ,Mendoza RT,Chong AK,et al.Application of the dorsal metacarpal artery perforator flap for resurfacing soft-tissue defects proximal to the fingertip.Plast Reconstr Surg,2011,128(3):166e-178e.
|
7. |
张文龙,张子明,高顺红,等.改良掌背动脉穿支皮瓣修复手指软组织缺损.中华创伤骨科杂志,2011,13(4):332-335.
|
- 1. Friedrich JB,Katolik LI,Vedder NB.Soft tissue reconstruction of the hand.J Hand Surg (Am),2009,34(6):1148-1155.
- 2. 姚群,芮永军,许亚军,等.不同远端蒂逆行掌背皮瓣修复手指软组织缺损.中华手外科杂志,2012,28(3):140-142.
- 3. 孙雪峰,史勇,简争光,等.远端蒂掌指背皮神经营养血管皮瓣修复手指皮肤缺损.临床和实验医学杂志,2011,10(24):1937-1939.
- 4. 周晓,芮永军,寿奎水,等.近节掌指背皮瓣修复指根部岛状皮瓣供区的临床应用.中华手外科杂志,2012,28(4):221-223.
- 5. Chen CC,Chang HH,Tang YB,et al.Combined first dorsal metacarpal artery flap and dorsal transposition flap for correction of extensive first web space contracture:a case report and literature review.Ann Plast Surg,2011,67(4):364-366.
- 6. Sebastin SJ,Mendoza RT,Chong AK,et al.Application of the dorsal metacarpal artery perforator flap for resurfacing soft-tissue defects proximal to the fingertip.Plast Reconstr Surg,2011,128(3):166e-178e.
- 7. 张文龙,张子明,高顺红,等.改良掌背动脉穿支皮瓣修复手指软组织缺损.中华创伤骨科杂志,2011,13(4):332-335.