微型皮瓣修复手指皮肤软组织缺损

Repair of soft tissue defects of the fingers with various kinds of mini free flaps

目的探讨对不同类型的手指皮肤软组织缺损,选用不同类型的微型皮瓣游离修复的方式和效果。方法根据损伤部位和特点,将手指皮肤软组织缺损分成9类,选用9种不同类型的微型皮瓣对170例手外伤进行游离移植修复。结果术后皮瓣存活168例,坏死2例。术后随访2个月～3年,皮瓣质地、外形及功能均较满意,两点分辨觉为6～10mm。手功能恢复满意。结论不同类型的手指皮肤软组织缺损应选用不同类型的微型皮瓣游离修复,皮瓣具有良好的血供,供区隐蔽,外形及功能恢复满意等优点,是修复手部皮肤软组织缺损较为理想的方法。

Objective To explorethe indications and results of different kinds of mini skin flaps in repairing soft tissue defects of the fingers. Methods According to locations and characteristics of the injury, 170 cases of soft tissue defects of the fingers were divided into 9 types. Nine kinds of mini free skin flaps were used for repair. Results Among 170 transplanted flaps, 168 flaps survived completely. Necrosis occurred in the other 2 flaps. Follow-up examination made 2 months to 3 years postoperatively revealed relatively satisfactory results in respect to blood supply, outward looking and function. Two-point discrimination ranged from 6 to 10 ram. Conclusion Choosing the most appropriate kind of miniature free flap to suit individual type of soft tissue defect of the fingers is the optimal way for reconstruction or repair. It has such advantages as good blood supply, texture and outward appearance of the flaps, satisfactory function of the recipient site, and minor morbidity of the donor site.