前臂骨间后动脉穿支感觉皮瓣修复手指皮肤缺损.pdfVIP

前臂骨间后动脉穿支感觉皮瓣修复手指皮肤缺损 王剑利 孙圣亮 王五洲 摘要： 目的 应用前臂骨间后动脉穿支感觉皮瓣对手指皮肤软组织缺损进行精确的定点修 复。方法 在前臂背侧远部，以骨间后动脉为轴线，用多普勒血流探测仪确定穿支部位后以 此设计皮瓣。对8例手指皮肤软组织缺损的患者，应用骨间后动脉穿支感觉皮瓣进行修复， 并观察和探讨该皮瓣的疗效。结果 术后7例皮瓣顺利存活，1例皮瓣术后2 d出现水疱、暗紫、 结痂，脱痂后成活。术后7例获得5-12个月的随访，1例失访。皮瓣外形满意，手指修复后感 觉功能良好。结论 前臂骨间后动脉穿支感觉皮瓣游离移植可对手指较小的皮肤软组织缺损 进行精确的定点修复，并获得了较好的临床效果。 关键词：外科皮瓣；指损伤；移植；骨间后动脉 Free posterior osteosseous perforating neurocutaneous flap of forearm transfers for reconstruction of finger defects YU Dong-li WANG cheng-qi WANG Jian-li PAN zhao-hui Abstract: Objective To apply posterior interosseous perforating neurocutaneous flap of forearm for accurate repairing of soft tissue defects of the fingers． Methods Doppler detection of the presence and site of the posterior interosseous perforator along the axis of the posterior interosseous artery was carried out in the dorsum of the forearm．the flap was then designed around the perforator site．8 cases of soft tissue defects in the fingers were treated by this flap． and treatment outcome were observed． Results 7 flaps survived uneventfully．1 flaps had signs of circulation crisis postoperatively for a few days． 7 cases had 5 to 12 months’ follow-up while 1 cases were lost to long-term follow-up．The appearance of the flaps Was satisfactory．Sensation of the fingers after repair was good． Conclusion For skin defects of the fingers posterior interosseous perforating neurocutaneous flap coverage is a good treatment option． key words： Surgical flaps； Finger injuries； transplantation； Posterior interosseous artery 随着现代化机械作业的广泛应用，手指的皮肤软组织伤在临床上比较常见。手是人体 重要的器官，手的功能缺失对人们日常生活造成重要影响，为使受损的手指修复后获得满意 的外形和感觉功能的良好恢复，2005年2月至2007年8月我们对手指皮肤软组织缺损设计和应 用前臂骨间后动脉穿支感觉皮瓣进定点修复，效果满意。 资料与方法 ㈠一般资料 本组男5例，女3例。年龄21～38岁．平均27岁。其中电刨伤2例，电锯伤3例，压轧伤3 例；拇指缺损1例，示指3例，中环指各2例；指腹缺损3，末节脱套2例，缺损位于指侧方3