侧方指动脉穿支皮瓣在手指远端缺损修复中的临床应用

Repair of fingertip defects with lateral flaps of finger based on digital artery perforator

目的探讨应用手指侧方指动脉穿支皮瓣修复指端缺损的临床疗效。方法2008年10月至2010年8月期间，应用手指侧方指动脉穿支皮瓣修复9例共12指指端部分缺损患者，其中拇指5指，示指2指，中指3指，环指2指。切取皮瓣面积为2．7cm×1．4cm～3．1cm×1．8cm，供区游离植皮修复。结果11例皮瓣血运良好，伤口一期愈合，1例术后出现皮瓣远端部分青紫，经局部换药3周后愈合。患者均获随访，随访3～6个月，皮瓣外形饱满，颜色质地接近正常。10例皮瓣术后3个月内两点辨别觉恢复至4．5mm。结论应用手指侧方指动脉穿支皮瓣修复指端缺损，避免了主干血管损伤，皮瓣外观、感觉恢复良好，疗效满意。

Objective To analysis the clinical efficacy of using lateral homodigital flaps based on digital artery perforator to repair the fingertip defects. Methods From October 2008 to August 2010, nine patients with twelve fingertip defects, including 5 thumbs, 2 index fingers, 3 middle fingers, 2 ring fingers, underwent repair with lateral homodigital flaps based on digital artery perforator. The size of the flaps ranged from 2.7cm×1.4cm～3.1cm×1.8cm. The donor site were covered by skin graft. Results Eleven flaps survived. One case met with partial necrosis. The follow-up time ranged from 3 to 6 months（average of 4.5 months）. The tinges had good appearance. Ten cases had gained full postoperative sensory recovery and the two-point discrimination was 4-Smm at 3 months after operation. Conclusion Using the flaps pedicled with digital artery perforator is a feasible solution for treatment of fingertip defects.