指蹼穿支蒂逆行掌背皮瓣修复手指创面

Application of reverse dorsal metacarpal flap based on webspace perforator for the coverage of finger defects

目的 探讨指蹼穿支蒂逆行掌背皮瓣在手指创面修复中的临床应用.方法 自2008年1月至2010年10月,应用以指蹼穿支为蒂的逆行2～4掌背侧岛状皮瓣修复手指近中节创面患者共16例,皮瓣切取范围2.0cm×2.5cm～3.0cm×4.5cm,供区创面Ⅰ期缝合.结果 16例逆行蒂掌背皮瓣均全部成活,根据创面缺损而设计的皮瓣外形良好,术后随访6个月至2年,皮瓣与周围皮肤颜色质地匹配,手指功能良好,皮瓣感觉有一定程度的恢复,供区影响小.结论 应用指蹼穿支蒂逆行掌背皮瓣设计简单灵活,操作容易,皮瓣血运可靠,对供区损伤小,具有较好的临床应用价值.

Objective To evaluate the role of the reverse dorsal metacarpal flap based on the webspaee perforator in the management of finger defects. Methods From January 2008 to October 2010, 16 patients with soft tissue defects in index, middle, ring and little fingers were treated by using the reverse dorsal metacarpal flap based on the webspace perforator. The flaps were harvested from 2.0 cm ×2.5 cm to 3.0 cm ×4.5 cm in size. The donor sites were closed primarily. Results All flaps were survived. After 6 to 24 months follow-up, all cases were satisfied with the good match of the transplanted tissues to the surrounding tissue in color and texture, and the good functional results as well as lower mobidity in donor sites. Conclusion The reverse dorsal metacar- pal flap based on the webspace perforator could effectively repair the finger soft tissue defects while improve the aesthetic appearance. The flap also has other several advantages such as simple design, one-stage reconstruction and reliable blood supply. The technique deserves popularization for its simplicity and effectualness.