第一趾蹼区游离皮瓣修复虎口及指腹缺损的疗效

Clinical outcome of first web flap transfer from the foot for coverage of first web and finger pulp defects

目的介绍用第一趾蹼区游离皮瓣修复虎口及指腹软组织缺损的疗效.方法对2例虎口瘢痕挛缩以及5例外伤后手指指腹软组织缺损者,采用第一趾蹼区游离皮瓣修复瘢痕切除后的创面和软组织缺损创面.供区用全厚皮片植皮.结果7例皮瓣全部存活.术后平均随访8个月,虎口开大为健侧的70%,手指指腹外形良好,屈伸自如,两点分辨觉为10～12mm.7例术后3个月足部行走正常,无疼痛;其中2例趾蹼处有瘢痕.结论应用第一趾蹼区游离皮瓣修复虎口及手指指腹皮肤缺损,手术虽然复杂,但术后感觉恢复满意.

Objective To evaluate the treatment outcomes of transfer of the web flap from the foot for coverage of soft tissue defect of the first web space and finger pulp. Methods First web flap from the foot was harvested and transferred to the hand for soft tissue coverage in 7 cases, among which 2 were scar contracture of the first web space and 5 were post-traumatic loss of finger pulps. The donor sites were closed by full thickness skin graft. Results All 7 flaps survived. Post-operative follow-up averaged 8 months. Opening of the contractured first web space reached 70% of the opposite side. The resurfaced fingers had good appearance and range of motion. 2-PD was 10-12 mm. Donor site morbidity included scar formation at the toe web in 2 cases. There was no pain. All patients could walk normally at 3 months post-operatively. Conclusion Transfer of the web flap from the foot for coverage of soft tissue defect of the first web space and finger pulp is technically demanding but rewarding in terms of sensory recovery.