静脉复合皮瓣修复指背复合组织缺损的方法及疗效

Application of arterialized venous composite flap in reconstruction of composite tissue defects on dorsum of the finger

目的探讨应用动脉化静脉复合皮瓣修复指背复合组织缺损的方法及疗效。方法2008年8月至2011年5月，应用动脉化静脉复合皮瓣修复指背皮肤合并肌腱的复合组织缺损12例16指，其中12指采用带掌长肌的动脉化静脉复合皮瓣，余4指采用动脉化静脉复合皮瓣＋游离掌长肌移植修复。结果皮瓣全部存活，术后随访9～24个月，平均13个月。手指外观、功能满意，无明显色素沉着，皮瓣感觉恢复良好（两点分辨觉平均为9mm）。结论动脉化静脉复合皮瓣修复指背复合组织缺损是一种简单而有效的方法。

Objective To explore the methods and feasibility of using arterialized venous composite flap in reconstruction of composite tissue defects on dorsum of the finger. Methods From August 2008 to May 2011, 16 fingers of 12 cases with combined skin and extensor tendon defects on the dorsal aspect of the finger were treated with the arterialized venous flaps. Defects were caused by friction injury in 10 patients and by hot press injury in 2 patients. Seven fingers sustained a more than 50% joint surface loss. Twelve fingers were reconstructed with the composite palmaris longus venous flaps and the other 4 were treated with arterialized venous flaps combined with free palmaris longus tendon grafts. Results All the flaps survived completely. Postoperative follow-up ranged from 9 to 24 months （average, 13 months）. The flaps had excellent appearance, good texture and color match. Functional recovery and sensory restoration were satisfactory with an average 2-PD of 9 mm. Conclusion The arterialized venous flap is a simple and effective option for reconstruction of composite tissue defects on dorsum of the finger.