穿支皮瓣移植在手指创面修复中的应用

Application of perforator flap for repair of finger soft tissue defect

目的探讨穿支皮瓣游离移植修复手指皮肤软组织缺损的设计和手术技巧。方法切取小腿前外侧、小腿内侧下部、小腿外侧血管穿支皮瓣以及远段骨间背血管蒂穿支皮瓣，移植修复手指小创面13例。结果13例皮瓣全部存活，受区与供区的功能、外观均良好。结论在肢体部位以皮穿支或轴型血管为蒂设计穿支皮瓣，游离移植修复手指创面，患者痛苦小、损伤小，创面能获得满意覆盖。这为手外伤修复提供了一种新的选择，对术者也提出了更高的要求。

Objective To explore the surgical design and surgical techniques of perforator flap transfer for repairing soft tissue defects of the fingers. Methods Perforator flaps from anterolateral, inferomedial and lateral side of the lower leg and distal dorsal interosseous perforator mini flap were used to repair soft tissue defect of the fingers in 13 cases. Results All 13 flaps survived. The function and appearance of both the donor and recipient sites were good. Conclusion Designing and harvesting a flap pedicled on a perforator or an axial vessel in the extremity for free transfer to cover soft tissue defects of the fingers offers a new surgical option for treating hand trauma, since it causes less pain and less damage while providing satisfactory wound coverage. Meanwhile, however, it is teclmically more challenging to the surgeon.