手指再造手术中甲瓣供区的修复

Donor site repair of great toe-nail flap in finger reconstruction surgery

目的探讨手指再造手术中跨甲瓣供区的修复方法。方法从1998年12月至2010年12月，共修复拇甲瓣供区511例，分别应用足背皮瓣32例、第1跖背皮瓣24例、第2跖背皮瓣21例、踝前皮瓣14例、跗内侧皮瓣17例、跗外侧皮瓣79例、跖底皮瓣106例、第2趾皮瓣79例、小腿中下段皮瓣15例以及游离皮瓣124例。结果皮瓣成活良好，术后经过6个月～11年随访，见皮瓣质地良好，外形满意，拇趾活动及负重行走、跑跳等皆不受影响。结论拇甲瓣供区的修复方法较多，各有优缺点。以跖底皮瓣及游离腹股沟皮瓣为优。

struction surgery Objective To explore methods of donor repair of the great toe-nail flap in finger recon- Methods From December 1998 to December 2010, various kinds of flaps were used in 511 donor sites to repair the great toe-nail flaps, including： 32 dorsal pedal artery flaps; twenty-four first dorsal metatarsal artery flaps; twenty-one second dorsal metatarsal artery flaps; forteen anterior malleolar flaps; seventeen medial tarsal artery flaps; seventy-nine lateral tarsal artery flaps; one hundred and six plantar metatarsal flaps, seventy-nine flaps from second toe; fifteen flaps from mid/lower leg and 124 freed flaps. Results After postoperative 6 months to 11 years of follow-up, repaired donor sites of great toe-flaps all survived successfully, with ideal outlook and function. Conclusion There are many kinds of methods for donor site repair of the great toe-nail flap, and each kind of method has its own advantages and disad- vantages. Among these flaps, plantar pedal artery flap and free groin flap are amony the best ones.