以指固有动脉为蒂的掌背动脉皮瓣修复手指中远节皮肤缺损

Dorsal metacarpal artery flap based on proper digital artery for repair of skin defects at middle and distal segment of fingers

目的报告以指固有动脉为蒂的掌背动脉皮瓣修复手指中远节皮肤缺损的方法及临床效果。方法对15例手指中远节皮肤缺损的患者，在应用逆行掌背动脉皮瓣修复中，采用延长掌背动脉指蹼交通支至指固有动脉，以指固有动脉为蒂旋转，修复手指中远节皮肤缺损。结果术后15例皮瓣全部存活，随访时间平均为10个月，皮瓣外形及功能恢复满意。结论采用指固有动脉为蒂的掌背动脉皮瓣修复手指中远节皮肤缺损，明显延长了皮瓣蒂部，减少了静脉危象的发生，使皮瓣可以达到手指远节任意长度，弥补了传统掌背动脉皮瓣蒂长度不足的缺点。

Objective To report the method and clinical results of repairing skin defects of the middle and distal segnent of fingers using the reverse dorsal metacarpal artery flap. Methods Fifteen cases of skin defects of the middle and distal segment ef fingers were repaired by the reverse dorsal metacarpal artery flap. The dorsal metacarpal artery was extended through web-space communicating branches to the proper digital artery which served as pedicle of the flap that was rotated to cover the middle and distal segment of the finger. Results All flaps survived in 15 cases with a success rate of 100%. The average postoperative follow-up period was 10 months. Both appearance of the flaps and function of the fingers were satisfactory. Conclusion The proposed method could significantly extend the length of flap pedicle and reduce the incidence of venous crisis. It overcomes the shortcoming of short pedicle in traditional dorsal artery flaps now that the flap can reach any part of the distal phalanx.