带血管蒂的邻指皮瓣修复手指末节皮肤脱套伤.PDFVIP

1480 Chinese Journal of Reparative and Reconstructive Surgery, December 2013, Vol. 27, No.12 · · 带血管蒂的邻指皮瓣修复手指末节皮肤脱套伤 卢俊岳 崔浩杰 张巍 李启朝 何奎乐 彭永利 边朝辉 【摘  要】    目的  探讨采用指固有动脉背侧支供血的邻指皮瓣修复2 ～5 指末节皮肤脱套伤的疗效。  方 法 2010 年1 月－ 2012 年6 月，收治13 例单指末节脱套伤患者。男9 例，女4 例；年龄 17 ～46 岁，平均33.6 岁。致伤 原因：机器绞伤4 例，绳索绞伤6 例，挤压伤3 例。损伤指别：示指5 例，中指3 例，环指3 例，小指2 例。皮肤撕脱范围均 为自远侧指间关节以远完全撕脱。脱套手指末节长度为1.0 ～2.1 cm ，平均1.8 cm。合并指骨骨折2 例。患者受伤至手 术时间为 90 ～330 min，平均150 min。应用大小为3.2 cm × 2.3 cm ～ 4.2 cm × 3.1 cm 的指固有动脉背侧支供血的邻指 皮瓣修复，术后3 ～4 周皮瓣断蒂。供区游离植皮修复。  结果  术后3 例皮瓣出现张力性水疱，1 例供区植皮部分坏死， 均经对症处理后愈合；其余皮瓣及供区植皮均顺利成活，创面Ⅰ期愈合。13 例患者均获随访，随访时间6 ～10 个月，平均 7 个月。皮瓣外形满意，质地优良，色泽正常，无破溃。术后6 个月，皮瓣两点辨别觉为7 ～10 mm，平均8.1 mm。采用手 指总主动活动度评分法对手指功能进行评价，获优10 例，良3 例，优良率 100%。  结论  以指固有动脉背侧支供血的邻 指皮瓣修复2 ～5 指末节皮肤脱套伤血供可靠，手术操作简便，皮瓣成活率高，术后皮瓣外观良好，患指功能恢复满意。 【关键词】    手指末节皮肤脱套伤    邻指皮瓣    指固有动脉背侧支    创面修复 REPAIR OF DEGLOVING INJURY OF FINGERTIP WITH VASCULAR PEDICLED CROSS FINGER FLAP/LU Junyue, CUI Haojie, ZHANG Wei, LI Qichao, HE Kuile, PENG Yongli, BIAN Zhaohui. Department of Hand Surgery, People’s Hospital of Renqiu, Renqiu Hebei, 062550, P.R.China. Corresponding author: CUI Haojie, E-mail: haojiecui@163.com 【Abstract 】 Objective To investigate the effectiveness of cross finger flap pedicled with the dorsal branch of proper digital artery in repairing degloving injury of the fingerti p. Methods Between January 2010 and June 2012, 13 cases of degloving injury of single fingerti p were treated, including 9 males and 4 females with an average age of 33.6 years (range, 17-46 years). The defect locations were index finger in 5 cases, middle finger in 3 cases, ring finger in 3 cases, and little finger in 2 cases, including 4 cases of mechanical injury, 6 cases of twist injury, and 3 cases of crushing injury. The extent of skin avulsion was bey