改良动脉化游离静脉皮瓣修复手指软组织缺损

Repairing soft tissue defect of finger by using modified arterialized venous skin flap

目的报道改良动脉化游离静脉皮瓣修复手指软组织缺损的方法。方法取同侧前臂双干静脉皮瓣，在两静脉干之间行连续“w”锯齿状切开处理，切开脂肪组织深至真皮下血管网，切断大部分交通支．保留少部分交通支，保证真皮下血管网的完整，可顺行或逆行移植。对14例软组织缺损患者，应用14块动脉化静脉皮瓣进行游离移植修复．并同时将前臂皮神经内、外侧的分支桥接移植指神经。结果术后14块皮瓣均成活，9块无明显肿胀与正常动静脉皮瓣相似，5块轻度肿胀伴水疱形成。术后随访12例，失访2例，时间6-12个月，平均8个月。皮瓣质地、外形及功能均较满意，两点辨别觉7～10mm．平均8．5mm。结论改良动脉化游离静脉皮瓣修复手指软组织缺损是一种可供选择的良好方法。

Objective To report the method for repairing soft tissue defect of finger by using modified arterialized venous skin flap. Methods Venous flaps of ipsilaterai forearm with two vein trunks were dissected,and the process of ＂W＂ jagged was performed.The adipose tissue of flap was cut oft to the subdermal vascular plexus. The most of the communication branches were ligated while keeping the subdermal vascular network intact.Anterograde and retrograde transfer of the flap were performed. Fourteen arterialized venous flaps processed with the above-deseribed modification were used to repair soft tissue defect in 14 cases, and the branches of medial or lateral antebrachial cutaneous nerve neurorrhaphy in the finger nerve. Results Nine of the 14 flaps survived uneventfully.There was no swelling at all. 5 flaps had slight swelling and sporadic blisters.The average postoperative following-up time was 8 months,ranging from 6 months to 12 months, 2 patients were lost, and all flaps obtained good results in blood supply,outward looking and functio. The two-point discrimination ranged 7 to 10 mm with an average of 8.5 ram. Conclusion Modified arterialized venous skin flap is a desirable method for repiring soft tissue defect of the fingers.