掌背皮神经营养血管蒂岛状皮瓣修复手指软组织缺损

Repair of the soft tissue defect of fingers with the island skin flap nourished by the cutaneous nerve nutrient vessel of the dorsum of hand

目的总结分析用掌背皮神经营养血管蒂逆行岛状皮瓣修复手指软组织缺损的疗效。方法2005年6月至2008年5月应用掌背皮神经营养血管蒂逆行岛状皮瓣治疗手指软组织缺损30例,其中男21例,女9例;30例中拇指末节缺损6例,拇指指背缺损4例,食指指腹缺损5例,中指指腹缺损3例,示、中指指背软组织缺损各5例,环指指背软组织缺损2例。急诊手术27例,择期手术3例。皮瓣最大面积5.0cm×3.5cm,最小面积3.0cm×2.5cm。结果28例皮瓣成活良好,2例皮瓣术后2～3d出现暗紫、肿胀、结痂,经对症处理脱痂后成活;经5～12个月随访,手指外形和功能恢复满意。结论掌背皮神经营养血管蒂逆行岛状皮瓣血供可靠,不损伤知名血管,操作简单,是修复手指软组织缺损较理想的皮瓣。

Objective To investigate the reverse island skin flap nourished by the cutaneous nerve nutrient vessel of the dorsum of hand in the repair of the soft tissue defect of fingers. Methods Thirty reverse island skin flaps nourished by the cutaneous nerve nutrient vessel were designed on the dorsum of hand along the cutaneous nerve for repairing finger soft tissue defect in 30 patients. The size of the reverse island skin flap ranged from 5.0 cm× 3.5 cm to 3.0 cm × 2.5 cm. Results Among the 30 case of flaps,28 cases survived,2 flaps had signs of circulation crisis postoperatively for a few days and suffered after treatment. The follow - up period was 5 - 12 months, the fingers repaired have good appearances and functions. Conclusion The reverse island skin flap nourished by the cutaneous nerve nutrient vessel of the dorsum of hand has reliable blood supply , without damage of a known vessel and easy manipulation. The anthor finds the method is an effective way to repair the soft tissue defect of fingers.