带感觉神经的静脉网动脉化皮瓣移植修复手指脱套伤

TRANSPLANTATION OF ARTERIOLIZED VENOUS NETWORK FLAP WITH SENSORY NERVE FOR REPAIRING DIGITAL DEGLOVE-INJURY

目的：报道带感觉神经的静脉网动脉化皮瓣修复单个手指脱套伤的效果。方法：在显微镜下清创找出伤者指断端的指动脉，指神经及指动脉吻合，２～３条浅静脉与指背静脉，在前臂掌侧设计相应的带３～５条浅静脉及皮神经的静脉皮瓣，顺行移植于伤肢皮肤缺损处，皮瓣内的皮神经与指神经缝合，２～３条浅静脉与指动脉吻合，２～３条浅静脉与指背静脉吻合。结果：６例７指皮肤脱套伤所植的皮瓣全部成活，伤指恢复良好的感觉，两点辩别觉５～１０ｍｍ。结论：此种皮瓣一次完成手指脱套伤皮肤及感觉缺损的修复，为临床提供了一种新的理想的修复方法。

Objective:To report the result of transplantation of arteriolized venous network flap with sensory nerve for repairing deglove injured finger.Metbods:To find out the digital artery,digital nerve and the dorsal digital veins under the microscope at the proxirnal end of the injured finger,designed venous flap with 3～5 superficial veins and cutaneous nerves at the palmar aspect of the fore- arm。The flap was transplanted gradually into the skin defect area of the injured finger。The anastomo- sis patterns were as follows:the cutaneous nerve of the flap anastomosed with digital nerves,2 superfi- cial veins with digital arteries,2～3 superficial veins with dorsal digital veins.Results:All the flaps were survived and the sensation of the injured finger was recovered excellently。Two point discrimination was 5～10mm. Conclusion:This kind of flap can repair the skin defect with lack of sensation of the deglove injured finger and reserve the function and the appearance of the hand greatly。