桡神经浅支营养血管皮瓣的临床应用

Clinical application of skin flap with superficial branches of radial nerve and its nourishing blood vessels

目的总结和探讨桡神经浅支营养血管皮瓣的临床应用效果。方法在第一掌背设计桡神经浅支营养血管皮瓣[黄河,吴迪,王义平,等.第一掌指背皮神经营养血管皮瓣转移修复拇指远端皮肤缺损[J].中华显微外科杂志,2005,28(1):64-65.],皮瓣面积最大为3.5c×m4.5cm,最小为2.0cm×2.5cm,修复创面最大面积为3.0cm×4.2cm,最小为1.8cm×2.0cm.结果自2007年6月—2008年10月,我们对5例拇指创伤后组织缺损的患者及3例虎口瘢痕挛缩患者进行手术治疗,全部采用桡神经浅支营养血管皮瓣修复创面。这8例患者皮瓣全部成活,没有发生血供不足及坏死的情况,外观和功能恢复良好,其中只有1例皮瓣需Ⅱ期整形。结论桡神经浅支营养血管皮瓣适合部分拇指创面及虎口附近创面的修复,皮瓣具有简单易取、安全、技术要求低、成活率高和外形较满意等优点。

Objective To study and conclude the clinical apphcation of skin flap with superficial branch of racial nerve and its nourishing blood vessels. Methods Designed skin flap with superficial branch of racial nerve and its nourishing blood vessels on the first dorsal metacarpal bone [Huanghe , Wu di, Wang yiping ,et al. Reparation of cutaneous deficiency in thumb distal end with skin flap with the first finger dorsal cutaneous nerve and its nourishing blood vessels[J]. CHINESE JOURNAL OF MICROSURGERY 2005,28 （1） ：64-65.]with an area of 3.5 cm × 4.5 cm at the maximum and 2.0 cm × 25 cm at the minimum and the repaired wound area ranging from 3.0 cm × 4.2 cm to 1.8 cm × 2.0 cm. Results 5 cases of tissue defect after thumb wound and 3 cases of scar contracture in the tiger mouth have received sugical operation using skin flap with superficial branch of racial nerve and its nourishing blood vessels to repair the wound. All the transplants survived with sufficient blood supply. The appearance and function of the wound were satisfactory except only one needed further reshaping. Conclusion Skin flap with superficial branch of racial nerve and its nourishing blood vessels is suitable for the wound in some thumb repair and wound near the hukou. It is convenient to operate with low technical requirement but high survival rate as well as satisfactory appearance.