掌背皮动脉逆行岛状皮瓣修复手指皮肤缺损.docVIP

掌背皮动脉逆行岛状皮瓣修复手指皮肤缺损【摘要】 目的 介绍应用掌背皮动脉逆行岛状皮瓣修复2~5指近中节皮肤缺损的方法。方法 对26例2~5指缺损的患者,应用掌背皮动脉逆行岛状皮瓣对手指皮肤缺损进行修复,其中第2掌背皮动脉皮瓣16例,第3、4掌背皮动脉皮瓣各5例。皮肤缺损面积为1.5cm×2.0cm~2.5cm×4.0cm。结果 26例皮瓣全部成活,供区创面Ⅰ期愈合。术后随访5～13个月,手指外形、功能满意,皮瓣质地、色泽与正常指相近,皮瓣不臃肿,两点辨别觉为8～11mm。结论 掌背皮动脉逆行岛状皮瓣操作方便,易切取,损伤小,不牺牲主干动脉,患者容易接受,皮瓣供区靠近创面,可同时修复多指皮肤缺损,术后皮瓣外形满意,是修复2~5指皮肤缺损较理想的手术方法。? 【关键词】 掌背皮动脉;皮瓣;皮肤缺损 Dorsal metacarpal skin artery reverse island flap to repair skin defect of the finger ZHAO Xue-shu, LIU Li-ping, GE Lian-jun. Liaoyuan Central Hospital, Liao Yuan City，Ji Lin Province，136200,China ? 【Abstract】 Objective To introduce the procedure of repairing thumb pulp defect by dorsal thumb neurocutaneous flap transfer. Methods Dorsal thumb neurocutaneous flap was applied in 16 cases of pulp defect of the thumb.In 16 case the flap was based on radial dorsal cutaneous branch of the thumb while in the other 5 cases the flap was based on the ulnar dorsal cutaneous branch.The size of the flaps ranged from 1.5 cm×2.0 cm to 2.5 cm×4.0 cm.The dorsal coetaneous nerve was coasted with the digital nerve. Results The patients were followed for 5 to 13 months. All 16 flaps survived with primary healing of the donor site. The appearance and function of the thumb was satisfactory.The flaps were not bulky, but with near normal color and texture. 2-PD recovered to 8-11 mm. Conclusion Dorsal thumb neurocutaneous flap is an optimal flap for coverage of defects of the thumb pulp. The donor site is close to the defect. Operation is relatively easy both on the surgeon and the patient. The flap has good appearance and is sensate.? 【Key words】 the coetaneous dorsal metacarpal artery ; Surgical flaps;Skin defect 第2~5指近、中节皮肤软组织缺损在手外伤中比较常见,手背部皮肤质地好,厚薄适中,有一定的伸缩性,并有掌背神经、伸肌键、掌骨等可做多种组织移植,因而,掌背皮动脉皮瓣及其复合组织瓣是一种修复手指多种组织缺损的理想手术方法[1]。2000～2010年我科应用掌背皮动脉逆行岛状皮瓣修复2~5指近、中节皮肤缺损26例,移植组织全部成活,手外形和功能均达到I期修复,疗效满意。? 1 资料与方法? 1.1 一般资料 本组26例,男18例,女8例;年龄20～55岁,平均37.5岁。损伤原因:挤压伤13例,电剧伤7例,电击伤6例。缺损面积1.5cm×2.0cm-2.5cm×3.0cm。手术方法第1掌背动脉皮瓣1