应用H形腹部真皮下血管网皮瓣修复多指皮肤缺损

Repair of degloving injury of the fingers using the H shape abdominal flaps with subdermal vascular plexus

目的介绍应用“H”形腹部真皮下血管网皮瓣修复多指皮肤套脱缺损的手术方法。方法对11例30指近指间关节以远皮肤套脱缺损的患者，采用“H”形腹部真皮下血管网带蒂皮瓣进行修复。结果术后11例30指（60块）皮瓣全部存活，随访时间为3个月至5年。患指运动功能较好，手指外观较满意，皮瓣无明显臃肿；60块皮瓣感觉恢复至S0级6块，S1级46块，S2级8块。按照中华医学会手外科学会手功能评定试用标准评定：优7例，良2例，差2例；优良率为81．8％。皮瓣供区无影响。结论该手术操作简单，效果良好，供区损伤小，对手外伤术后的功能恢复具有较高的临床价值。

Objective To introduce a surgical procedure for repair of skin degloving injury of the fingers using H shape abdominal flaps with subdennal vascular plexus. Methods Eleven eases （30 fingers） of skin degloving injury of the fingers distal to the proximal interphalangeal joint were treated with several H shape abdominal flaps with subdennal vascular plexus. Early functional exercises were carried out postoperatively. Results Sixty H shape abdominal flaps for the 30 fingers of 11 cases all survived. Postoperative follow up ranged from 3 months to 5 years. The involved fingers had good movement. The appearance of the fingers was satisfactory without flap bulkiness. Sensory recovery of the 60 flaps reached So in 6, S1 in 46 and S2 in 8. According to the criteria of Chinese Hand Surgery Society, the functions of these fingers were evaluated as good in 7 cases, fair in 2 eases and poor in 2 cases. The overall excellent and good rate was 81.8%. Threr was no morbidity at flap domorsite. Conclusion The H shape abdominal flaps with subdennal vascular plexus is an ideal option for repairing skin degloving injury of the fingers. It is simple, has minimal donor site morbidity and is a valuable option for functional recovery.