桡动脉腕部皮支穿支蒂皮瓣修复手部创面

Radial artery perforating cutaneous branch flap of the wrist for repair of defects of the hand

目的报告桡动脉腕部皮支穿支蒂皮瓣修复手部皮肤软组织缺损的方法及疗效。方法2008年1月至2011年6月，对15例手部皮肤软组织缺损患者，根据皮肤软组织缺损情况，应用桡动脉腕部皮支穿支蒂皮瓣修复，皮肤缺损面积为2．5cm×2．8cm-4．6cm×9．5cm，皮瓣切取面积为2．8cm×3．0cm-4．8cm×9．7cm。结果术后1例皮瓣出现蒂部卡压症状，经行血管探查、减压术后存活，余14例皮瓣及供区植皮全部存活。随访时间为6-12个月，皮瓣外形良好，质地及功能满意。结论桡动脉腕部皮支穿支蒂皮瓣血管相对恒定，外形美观，手术操作简便，是修复手部皮肤软组织缺损的有效手术方法之一。

Objective To report the method and clinical results of repairing skin and soft tissue defects of the hand using the radial artery perforating cutaneous branch flap of the wrist. Methods From January 2008 to June 2011, the radial artery perforating cutaneous branch flap of the wrist was used to repair defects of the hand in 15 patients. The flap was designed based on the size and shape of the defect. The sizes of the soft tissue defects ranged from 2.5 cm × 2.8 cm to 4.6 cm ×9.5 cm. The areas of the harvested flaps ranged from 2.8 cm× 3.0 cm to 4.8 cm× 9.7 cm. Results Compression of the vascular pedicle occurred in one case postoperatively. The vascular crisis was corrected by immediate surgical exploration and decompression and the flap survived. The remaining 14 flaps and the donor site skin grafts survived uneventfully. After 6 to 12 months＇ follow-up, the texture of the flap was found to he soft and the appearance and function of the hand satisfactory. Conclusion The perforating cutaneous branch of the radial artery is relatively constant. Flap harvesting is simple. The postoperative appearance is good. This flap is an effective method to repair soft tissue defects of the hand.