吻合指动脉皮支的近节指背筋膜蒂岛状皮瓣的临床应用

Clinical application of dorsal proximal phalanx fasciocutaneous island flap with anastomosis of cutaneous branch of the digital artery

目的探讨利用吻合指动脉皮支的近节指背筋膜蒂岛状皮瓣逆行转移修复同指指端缺损的手术操作方法及治疗效果。方法自2014年5月至2016年8月,我们应用吻合指动脉皮支的近节指背筋膜蒂皮瓣逆行转移修复9例(9指)指端皮肤软组织缺损患者,所有患者均有骨外露,缺损面积为1.2 cm×1.3 cm^1.7 cm×2.0 cm。结果术后所有伤口均Ⅰ期愈合,皮瓣全部存活。术后随访时间为8~14个月,平均11个月。手指功能及外观满意,指端皮瓣饱满,蒂部不臃肿,感觉恢复良好,指端两点分辨觉为5~8 mm。结论吻合指动脉皮支的近节指背筋膜蒂岛状皮瓣血供可靠,不牺牲指动脉,对供区影响小。术后外观满意,感觉恢复好,是指端创面修复的一种较理想术式。

ObjectiveTo explore the operative method and clinical efficacy of retrograde transfer of dorsal proximal phalanx fasciocutaneous island flap with anastomosis of cutaneous branch of the digital artery for repair of fingertip defect of the same finger.MethodsFrom May 2014 to August 2016,9 cases(9 fingers)of fingertip soft tissue defects were treated by retrograde transfer of dorsal proximal phalanx fasciocutaneous island flap with anastomosis of cutaneous branch of the digital artery.All the patients had bone exposure.The defect area ranged from 1.2 cm×1.3 cm to 1.7 cm×2.0 cm.ResultsAll the flaps survived uneventfully with primary healing in the wounds.The postoperative follow-up period ranged from 8 to 14 months,with an average of 11 months.The function and appearance recovery of fingers were satisfactory.The fingertip flaps were full without bulky pedicle.The sensory function recovered well.The fingertip two-point discrimination was 5 to 8 mm.ConclusionThe dorsal proximal phalanx fasciocutaneous island flaps with anastomosis of cutaneous branch of the digital artery have reliable blood supply without sacrificing the digital artery and little influence on the donor site.It is suitable for repairing fingertip defects with good appearance and sensory recovery.