改进的骨间背侧动脉逆行岛状皮瓣修复手部创伤

Revised antidromic dorsal interosseous artery island flap to repair injuried hand

目的对骨间背侧动脉逆行岛状皮瓣修复手部创伤的方法进行改进。方法将皮瓣的血管蒂改良为筋膜血管蒂;皮瓣与扩张术相结合;采用带尺骨瓣的复合组织瓣转移。结果 20块皮瓣及 3块复合组织瓣全部成活;前臂背侧皮瓣供区均免予植皮而直接缝合;15例患者得到平均15个月随访,皮瓣色泽、质地好,感觉恢复满意;综合评定手功能,平均失能值18％;3例复合组织瓣再造拇指功能评价为:优1例,良2例。结论如上改进增加了皮瓣静脉回流,提高了皮瓣成活率;保全了前臂的美观;扩大了该皮瓣的应用范围。

Objective To revise the method, which was used to repair injuried hand with an-tidromic dorsal interosseous artery resupinated island flap.Methods Blood vessel pedicle of flap was revised to fasciocutaneous pedicle .The flap and skin expanding method were used together. The flap (fasciocutaneous and adipofascied) was transfered to repair injuried hand. Results 20 flaps and 3 complex flaps (fasciocutaneous and adipofascied) were successful. The dornor of flap was directly sutured without dermoplasty. After 15 months following-up of 15 patients, the external appearance quality and feeling was recovered well. Assessing the hand function, the average losting function cost was 18%. 1 case was better, and 2 cases were good among 3 flaps (fasciocu-taneous and adipofascied) of restoring thumbers.Conclusion The revisement could increase vein reflux of flap, improve rate of success, preserve appearence of forearm, and enlarge the application scope of flap.