指背神经筋膜蒂逆行皮瓣修复指端部分组织缺损

Repair of partial tissue defects of the finger tip by using fasciocutaneous reverse flap pedicled dorsal digital nerves

目的探讨一种修复手指指端部分组织缺损的新方法。方法自2002年7月至2007年7月,采用指背神经筋膜蒂逆行皮瓣对87例(113指)手指指端部分组织缺损的患者进行修复,并对修复皮瓣的血液循环及远期回缩情况进行观察。结果所有患者的皮瓣全部成活。术后2～4 d,有49指的皮瓣表面有水疱形成,颜色发紫,于5～7 d自行缓解,未影响皮瓣成活。随访87例患者4～15个月,皮瓣质地佳,手指的外形及感觉恢复良好,2-PD为6～9 mm,皮瓣面积的回缩率为10%。供区自上臂或前臂内侧取全厚皮片植皮修复,愈合良好。结论指背神经筋膜蒂逆行皮瓣修复手指皮肤缺损具有操作简单、不牺牲主要动脉等优点,可以在临床上推广应用。

Objective To study a new method for the repair of tissue defects of the finger tip. Methods From July 2002 to July 2007, tissue defects of the finger tip in 87 patients （113 fingers） were repaired using fasciocutaneous reverse flap pedicled dorsal digital nerves, and the blood circulation of the flap used for repair and long - term retraction was observed postoperatively. Results All flaps survived; on the flap surface of 49 fingers water vacuoles appeared and showed violet coloration at 2--4 days after operation, which resolved within 5- 7 days without affecting the survival of the flaps. After 4 -- 15 months follow - up, all paients were satisfied with the appearance and texture of the skip flaps and recovery of sensation （2 - PD, 6-- 9 mm）, Retraction of the flap area was 10%. The donor areas were well healed after transplantation of fullthick flaps from upper limbs or internal forearms. Conclusion The repair of tissue defects of the finger tip using fasciocutaneous reverse flap pedicled dorsal digital nerves is characterized by straightforward operative technique without sacrifice of major arteries, and this method merits morewide spread clinical application.