指背岛状筋膜瓣在手部软组织缺损修复中的应用

Dorsal digital fascial flap wed in homodigital reconstruction

目的 探讨一种修复指背软组织缺损的有效方法 ,并扩大其应用范围。方法 利用指掌侧动脉与指背侧动脉系统之间的动静脉吻合网 ,形成指背岛状筋膜瓣 ,修复同指背侧软组织缺损 ;将其与同指指动脉神经蒂岛状皮瓣串联后可修复手部其他部位软组织缺损。结果 手外伤急诊应用 39例 ,效果良好。结论 指背岛状筋膜瓣是I期修复同指指背软组织缺损的有效方法 。

Objective To get a much effective method for reconstruction of soft tissue defect in difficult dorsal digital area and other area of hand. Methods With a pedicle consisting of arterial and venous networks in the dorsal digital adipo so fascial layer based on their numerous connections with the volar digital arteries, the dorsal digital fascial flap were transposed homodigitally to cover dorsal soft tissue defects. Combining with the innervated island flap pedicled with the same digital artery, the flap could be transposed to other places of the hand. Results Distal necrosis took place in 3 dorsal digital fascial flaps among 19 cases of homodigital reconstruction. There was only 1 necrosis in 20 combined flap cases. Conclusion It would seem to be a relatively simple effective way to recover difficult dorsal digital defect and other areas without requirement of distant flap transposition and immobilization of adjacent digits.