指背动脉蒂逆行岛状皮瓣修复指端皮肤缺损

Repairing the Soft Tissue Defect of Fingertip with A Pedical Reverse Island Flaps of Dorsal Digital Artery

介绍一种修复手指末端皮肤缺损的新型逆行岛状皮瓣.对12只新鲜尸体手标本分别经桡动脉灌注红色乳胶及制作动脉铸型标本对照观察,并对掌背动脉及指背动脉进行显微解剖,可见掌背动脉与掌侧动脉在近节指骨底有交通支相连,掌背动脉的终末支指背动脉,与指掌侧固有动脉的背侧分支在指背形成丰富的血管吻合网.指背动脉与指掌侧固有动脉的吻合支丰富,可以其为蒂,设计成逆行岛状皮瓣.2002年6月～2004年8月,临床应用该皮瓣修复手指末端皮肤缺损16例,皮瓣全部成活,平均随访11(2～26)个月,所有皮瓣质软、弹性好,供区无明显畸形,患者满意.该皮瓣设计合理、血供可靠、操作简便,适于手指末端软组织缺损的修复.

To introduce a new reverse island flap for re pa iring soft tissue defect on fingertip. 12 fresh adult cadaveric hand specimens w ere observed after vascular dyestuff perfusion and arterial casting. The microsu rgical dissection of vessels at dorsal metacarpal artery and dorsal digital arte ry were studied. The dorsal metacarpal artery anastomosed with the palmar artery at the level of the first phalanx neck,the dorsal digital artery was the last part of the dorsal metacarpal artery. There were a lot of vascular collaterals b etween dorsal digital artery and palmar artery. The reverse island flaps with th e pedicel of dorsal digital artery was designed according to the distribution of vessels. From June 2002 to August 2004, 16 cases of soft tissue defect of the f ingertip were repaired with this kind of flap. All 16 flaps survived well withi n 2 to 16 months follow-up. The subcutaneous dorsal digital artery can be desig ned as pedicel of reverse island flaps, it is practicable and valuable in repair of the soft tissue defect of the fingertip.