指背筋膜皮瓣修复手指软组织缺损

Repairing skin defects of fingers with dorsal metacarpal fascial flap

目的分析使用多重血供的指背筋膜皮瓣修复手指皮肤缺损的疗效。方法 2010年1月-2013年12月使用具有三重血供的指背筋膜皮瓣修复手指软组织缺损39例49指,切取面积2.0 cm×1.5 cm^3.5 cm×2.7 cm。结果术后皮瓣全部成活,随访6个月到1年时间,皮瓣两点间分辨觉为4.5~9.0 mm,平均为6.3 mm,手指活动无障碍,无冻伤烫伤。结论多重血供的指背筋膜皮瓣具有血供可靠、损伤小、质地与受区一致,皮瓣感觉恢复较好等特点,是修复手指软组织缺损的较理想方法。

Objective To investigate the application of dorsal metacarpal fascial flap with multiple feeding vessels for re -pairing skin defects of fingers.Methods From January 2010 to December 2013,39 cases （total number of 49 fingers） of skin defects were treated with dorsal metacarpal fascial flap with multiple feeding vessels .The flap is supplied by multiple feeding vessels including dorsal cutaneous branches of the proper digital artery , nutrient vessels of dorsal cutaneous branches of the proper digital nerve ,and the deep fascial vascular network .The size of the flaps ranged from 2.0cm ×1.5cm to 3.5cm × 2.7cm.Results All flaps survived after the operation .The patients were followed up for 6 to 24 months.Two-point discrimina-tion of the flaps recovered to 4.5 to 9.0mm,with an average of 6.3mm.Movement of the interphalangeal joint was normal .No frostbite and scald occurred in all cases .Conclusion The application of phalangeal reverse island flap with multiple feeding vessels has reliable blood supply ,does not sacrifice a major artery and can restore good flap sensation .It is an ideal therapy for repairing skin defect of fingers .