掌背皮神经营养血管及筋膜蒂逆行岛状皮瓣的临床应用

CLINICAL APPLICATION OF RETROGRADE NEUROCUTANEOUS FASCIAL ISLAND FLAP ON DORSAL PART OF HAND

目的：报道以掌背皮神经伴行血管丛供血的逆行岛状皮瓣的应用解剖和临床应用评价。方法：自１９９３年以来通过３６侧成人上肢标本观察研究了国人掌背尺桡神经浅支的分布类型、横径、伴行血管数量、口径等。结果：伴行血管平均１～２支，口径０．２～０．４ｍｍ。临床应用１９例，２０块皮瓣，全部成活，效果满意。结论：该皮瓣血供可靠，长宽比例可达４．８：１，蒂最长达５～６ｃｍ。能满足指端修复需要。最大优点手术操作简单，供区损伤小，易被推广应用。

Objective:This paper reports applied anatomy and clinical application of retrograde island flap whose blood is supplied by the vascular plexus around and inside the nerve on dorsal part of the hand.Metheds:The position,number of blood vessels and size of superficial radial and ulnar nerve on dorsal part of the hand were dissected and measured.Results:There are 1-2 blood vessels, Its diameter 0.2～0.4 mm,Nineteen operations of this kind have been performed.All skin flaps were survival and the effects were ideal.Conclusions:The blood,supply of the flap is good.The length of pedicle can be 5～6cm.The ratio between length and width can be 4.8:1.It can meet the demands of reconstructing fingertip and finger-cushion.This method is operated and spreaded easily,it is small for the donor defect.