尺神经腕背支营养血管逆行皮瓣的临床应用

Clinical application of reverse flap of wrist dorsal branch of ulnar nerve nutriment blood vessel

目的探讨应用尺神经腕背支营养血管逆行皮瓣修复小指皮肤缺损的临床效果及手术操作要点。方法以尺神经腕背支营养血管远端为蒂,选择小指尺侧分支为皮瓣轴心血管,将皮瓣向小指远端转移,修复小指掌背侧皮肤缺损8例。结果8例全部成活,其中1例因创面止血不彻底,皮瓣受压导致远端部分坏死,经换药后痊愈。结论尺神经腕背支走向较恒定,本组未发现变异。沿皮神经干有纵行的皮神经旁血管网及皮神经干内血管网,此皮瓣血供可靠的,皮瓣切取容易,对供区影响小,是修复小指皮肤缺损的理想方法。

objective To summarize the clinic result and surgical essence of repairing the skin defect of little finger by reverse flap of wrist dorsal branch of ulnar nerve nutriment blood vessele. Methods With wrist dorsal branch of ulnar nerve nutriment blood vessels as distal pedicle,and ulnar branch of little finger as flap axis blood vessel, flap was transferred the flat to the distal part of little finger to repair the skin defect of dorsal little finger in 8 cases.Results Eight cases completely survived, 1 case had partial necrosis due to incomplete hemostasia and pressent. But it was healed with medicine. Conclusion Wrist dorsal branch of ulnar nerve maintains stable, and no aberrance is found. There are vertical cutaneous vascular net and beside and inside cutaneous nerve trunk. Blood supply in this flap is dependable. The flap is easy to cut and has little influence on donor site. It is an ideal method for repair of cutaneous defect of little finger.