足母趾背动脉皮瓣游离移植修复手指皮肤缺损

Outcome of free flap vascularized by the dorsal artery of big toe in treating finger skin defect

目的探讨应用足母趾背动脉皮瓣游离移植修复手指皮肤缺损的方法及临床效果。方法2010年8月至2013年4月，设计以躅趾背动脉为蒂的躅趾背皮瓣游离移植修复手指皮肤缺损21例。年龄21～48岁，其中男15例，女6例；拇指6例，示、中指15例；指背皮肤缺损7例，指腹皮肤缺损14例；急诊手术修复9例，亚急诊修复12例。切取皮瓣面积2．2cm×1．6cm～4．0em×3．2cm。通过随访观察手指外形、功能恢复情况。结果21例皮瓣全部成活。随访6～18个月，移植的躅趾背动脉皮瓣颜色、质地与手指相近，外形满意，指纹生长良好，两点分辨觉恢复至6～8mm，供足功能无影响。结论应用躅趾背动脉皮瓣具有血管解剖恒定、切取方便、外形功能满意、供区损伤小等特点，是精细修复手指中、小面积皮肤缺损的理想方法。

Objective To evaluate the outcome of the procedure of using the free flap vascularized by the dorsal artery of big toe to treat finger skin defect. Methods From August 2010 to April 2013, 21 cases of finger shin defect were treated with the free flap vascularized by the dorsal artery of big toe in which emergency surgeries were conducted in 9 cases and sub emergency surgeries were conducted in 12 cases. The age of the 21 patients was 21 to 48 years old and 15 of them were males and 6 were females. Thumb was involved in 6 patients and index finger was involved in 15 patients. The skin defect occurred at dorsal in 7 patients and palm in 14 patients. The area of the flaps ranged from 2. 2 cm x 1.6 cm to 4. 0 cm ~ 3.2 cm. Observed the restoration of the affected fingers＇ appearance and function, investigated the clinical results and concluded the indication and advantages and disadvantages of this procedure by following up. Results All of the 21 flaps survived at the last office visit. The follow-up period ranged from 3 to 18 months. The shapes and the fingerprints of the flaps were satisfied. The color and texture of the flaps were similar to those of the finger skin. The 2 points discriminations of the flaps was 6-8 mm. No function deficits were found in the donor feet. Conclusion This free flap is satisfied in the shape, easy to harvested and the blood supply was constant in its location, and recommend it in treating the small of middle area skin defect in the finger.