头静脉-桡神经浅支营养血管蒂皮瓣修复手部皮肤缺损

Superficial branches of radial nerve-cephalic vein neuro-veno-fasciocutaneous flap for skin defects in hand

目的报道应用头静脉-桡神经浅支营养血管皮瓣修复手掌部创面的临床效果。方法在前臂桡侧设计并切取头静脉-桡神经浅支营养血管筋膜皮瓣,逆行转位修复手掌背部及虎口皮肤软组织缺损11例。皮瓣切取面积最大为12 cm×8 cm,最小为6 cm×5 cm。结果11例中除2例皮瓣远端浅表坏死外,9例皮瓣全部成活,经6～48个月随访,外形和功能满意。结论头静脉-桡神经浅支营养血管岛状筋膜皮瓣血供可靠,操作简便,可以修复虎口、手掌和手背桡侧及近指间关节以近的软组织缺损。

Objective To report the clinical effects of repairing skin defects in hand by reversed neuro-veno-faseiocutaneous flaps based on the superficial branches of radial nerve. Methods Eleven cases with soft tissue defects around the wrist and the dorsum of the hand were treated with superficial branches of radial nerve-cephalic vein neuro-veno-fasciocutaneous flaps. Results The flaps totally survived in the 9 cases, the others were small distal necrosis. Follow-up survey in the（6-48 ）months after the operation showed the appearance and function were satisfactory. Conclusion Superficial branches of radial nerve neurofasciocutaneous flap is well supplied with blood and easy to perform. It is the ideal flap to repair the skin defects of the first finger web, radial palm and dorsum of hand.