不同穿支蒂的足内侧皮瓣修复手指皮肤缺损

Medial plantar flaps based on different cutaneous perforators to repair soft tissue defect of the fingers

目的 总结不同穿支蒂的足内侧皮瓣修复手指皮肤软组织缺损的选择及临床应用疗效.方法 对29例手指皮肤软组织缺损,分别采用以足底内侧动脉深支内侧深支皮支为供血动脉的足内侧皮瓣修复指腹及指侧方缺损5例;以足内侧动脉浅支为供血动脉的足内侧皮瓣修复手指掌侧皮肤缺损及指侧方皮肤缺损10例;以内踝前动脉为供血动脉的足内侧皮瓣修复指背皮肤缺损及指侧方皮肤缺损11例;以多皮支动脉供血的足内侧皮瓣修复手指中节、近节环形缺损3例.结果 术后29例皮瓣全部存活,术后23例获得6～13个月的随访.皮肤弹性、色泽良好,两点分辨觉6～9mm.结论 足内侧供区隐蔽,皮瓣切取方便,不损伤动脉主干,皮肤质地与手指相近,应用不同皮穿支的足内侧皮瓣移植是一种修复手指皮肤软组织缺损较理想的方法.

Objective To summarize the selection of medial plantar flaps based on different cutaneous perforators to repair soft tissue defect of the fingers and the clinical outcomes. Methods Twenty-nine cases of soft tissue defects of the fingers were treated with medial plantar flaps based on different perforators： medial deep perforator of the medial plantar artery flaps to repair volar and lateral finger defects in 5 cases, superficial branch of the medial plantar artery to repair palmar finger defects and lateral finger defects in 10 cases, the anteromedial malleollous artery to repair dorsal and lateral finger defects in 11 cases, multi-cutaneous branches of medial plantar artery to repair circular defects at proximal and middle phalanx level in 3 cases. Results All 29 flaps survived, with 23 cases followed for 6 to 13 months. The color and texture of the flaps were excellent. Two-point discrimination was 6 to 9 mm. Conclusion These series of flaps are characterized by easy dissection, hidden donor site, preservation of major vessels, flap texture similar to the skin of the fingers. Medial plantar flaps based on different cutaneous perforators are an ideal method to repair finger skin defects.