带神经的指动脉残端蒂皮瓣修复指端皮肤缺损

Digital artery and nerve stump pedicle flap for repair of fingertip skin defects

目的 利用指动脉残端及创面周围皮肤软组织设计皮瓣,介绍修复指端皮肤缺损的手术方法.方法 2013年1月至2013年4月,采用以一侧指固有动脉神经束残端为皮瓣蒂部或旋转点的两种方法修复指端皮肤缺损16例.观察皮瓣存活及手功能恢复情况.结果 16例皮瓣全部存活.术后随访时间1～3个月,早期皮瓣两点分辨觉为5～ 10 mm.根据中华医学会手外科学会上肢部分功能评定试用标准评定：优13例,良3例;优良率为100％.讨论 采用携带指神经的指动脉残端蒂皮瓣修复指端皮肤缺损,创伤小,操作简便,静脉回流好,功能外观满意,是一种非常理想的手术方式,值得推广.

Objective To introduce two new methods for repairing fingertip skin defect by designing flaps through the use of digital artery stump and skin around the wound.Methods Between January 2013 to April 2013,16 cases of skin defects of the fingertip were treated with flaps pedicled on or pivoted around the digital neurovascular stump.Survival of the flap and recovery of the hand function were evaluated.Results All 16 flaps survived.Postoperative follow-up of 1 to 3 months revealed two-point discrimination of 5 to 10 mm in the flaps.According to the upper limb functional assessment criteria issued by the Chinese Medical Association Hand Surgery Society,the results were excellent in 13 cases and good in 3 cases,the satisfactory rate being 100％.Conclusion Transfer of flap pedicled on the digital artery and nerve stump is an ideal procedure to repair fingertip skin defect in that it causes little trauma,is easy to operate,has good venous drainage,and leads to satisfactory functional and aesthetic results.