腕前区游离静脉皮瓣修复断指血管与皮肤缺损

Free Venous Flap of Anterior Carpal Region for Repairing the Vessel and Skin Defect in Severed Finger Replantation

目的总结游离静脉皮瓣在伴有血管及皮肤缺损的断指再植中的应用效果。方法临床应用18指,其中伴掌侧皮肤缺损15指,背侧皮肤缺损3指,从腕前区切取适宜大小的、带有皮下静脉和掌长肌腱的游离皮瓣植于手指组织缺损处,掌侧部位皮瓣倒置,背侧则同方向放置。结果除1例中指中节离断伴背侧血管和皮肤缺损于术后第3 d坏死外;17例术后手指均成活,外观及功能良好,功能评价:优11指,良4指,可2指。结论应用腕前区游离静脉皮瓣修复断指血管与皮肤缺损,效果良好,且简单易行。

Objective To assess the effect of free venous flap of anterior carpal region for repairing the vessel and skin defect in severed finger replantation.Methods 18 fingers（18 cases） were repaired by the free venous flap with subcutaneous vein and tendon palmaris longus from anterior carpal region,including retrograde flaps in 15 fingers with volar skin defect and antegrade flaps in 3 fingers with dorsal skin defect.Results The flaps of 17 fingers were survived with good shape,and the function evaluation was excellent in 11,good in 4,and fair in 2.Necrosis occurred in 1 case of severed middle phalanx in middle finger with dorsal vessel and skin defect.Conclusion It is simple and effective method for repairing the vessel and skin defect in severed finger replantation with free venous flap of anterior carpal region.