前臂微型穿支皮瓣修复手指皮肤缺损

Clinical applications of forearm perforator flaps for repairing skin defect of the finger

目的探讨前臂微型穿支皮瓣修复手指皮肤缺损的临床应用。方法对13例手指皮肤缺损患者，缺损面积为1．8cm×3．0cm～2．6cm×5．0cm，分别以桡、尺动脉为轴心血管，切取前臂微型穿支皮瓣修复。其中7例指神经与皮神经缝合。前臂供区直接缝合。结果13例皮瓣全部存活，4例3个月后行皮瓣整形术。术后随访2个月至2年，平均7个月，手指功能与外观满意，皮肤饱满，7例缝合皮神经的皮瓣感觉恢复良好，两点分辨觉为4～6mm。结论前臂微型穿支皮瓣游离移植修复手指皮肤缺损是一种较为理想的方法。

Objective To explore the clinical-applicatio-ns of perforator flaps of the forearm for repairing skin defect of the finger. Methods Thirteen cases with skin defects of the fingers measuring from 1.8 cm × 3.0 cm to 2.6 cm × 5.0 cm were treated with forearm perforator flaps. Mini-flaps based on perforators of either the radial artery or ulnar artery were harvested and transferred to cover the defects. The cutaneous nerve of the flap was coapted to the digital nerve of the recipient finger in 7 cases. All the forearm donor sites were directly dosed. Results All 13 flaps survived. Secondary flap plasty was done in 4 cases 3 months after the first operation. Postoperative follow up ranged from 2 months to 2 years, with an average of 7 months. The function and appearance of the fingers were satisfactory. Two-point discrimination recovered to 4 to 6 mm in the cases that underwent nerve coaptation. Conclusion Mini forearm perforator flap transfer is an ideal method for repairing skin defect of the finger.