指固有动脉皮支血管链逆行侧方皮瓣修复手指软组织缺损

Flap Pedicled with Lateral Vascular Chain of Cutaneous Branch of Digital Artery to Repair the Soft Tissue Defect of the Distal Finger

目的探讨指固有动脉皮支血管链逆行侧方皮瓣修复手指远端软组织缺损的效果。方法以指固有动脉背侧皮支上行支、下行支形成的链式吻合供血,在手指近节侧方切取皮瓣。皮瓣的轴线是手指侧方中线,皮瓣旋转点为中节指体中远端,皮瓣的蒂部宽度为0.5~1.0cm。皮瓣携带指背神经与创面指神经断端进行缝合修复,重建手指感觉。逆行移位皮瓣修复指端创面32例。结果 32例皮瓣全部成活。术后随访6个月~1年,皮瓣外形与正常相近,弹性、色泽良好。缺损饱满而不臃肿,质地柔软,有排汗功能,两点辨别觉达5~9mm。结论采用指固有动脉皮支血管链逆行侧方皮瓣一期修复指端缺损,疗程短,效果好,操作简单,血供可靠,不牺牲指固有动脉、神经,供区损伤小,术后并发症少,并且能重建皮瓣感觉,是一种理想的手术修复方法 。

Objective To explore the effect of flap pedicled with lateral vascular chain of cutaneous branch of digital artery to re -pair the soft tissue defect of the distal finger .Methods The flap based on the dorsal cutaneous branch of digital artery ,the ascending branch and the descending branch formation of supply vascular chain in the finger＆#39;s lateral.The axis of the flap was finger lateral midline , the rotation point of flap was the middle finger of the distal , and the pedicle width of flap was 0.5~1.0cm.Flap repaird dorsal nerve and stump nerve , reconstructed of the finger＆#39;s feeling.Retrograde transposition of flap in 32 cases to repair finger end .Results All flaps survived in 32 cases. After followed up for 6 months^1 years,flap had the normal close,elastic,good colour.Defect was full and not bloated , and soft texture,had the function that discharge sweat ,two-point discrimination Jueda 5~9mm.Conclusion Flap pedicled with lateral vascular chain of cutane-ous branch of digital artery to repair the finger tip defect ,has a short course of treatment ,good effect,simple operation,reliable blood supply, without sacrificing the proper digital artery ,nerve ,injury the supply area .less postoperative complications ,and is able to reconstruct the sensa-tion of the flaps ,is an ideal operation method .