桡动脉穿支逆行皮瓣修复手及腕部创伤的临床疗效

Clinical application of radial artery perforator flap for repair of defect in hand and wrist

目的探讨桡动脉穿支逆行皮瓣修复手及腕部创伤的临床疗效。方法对应用桡动脉穿支逆行皮瓣修复手及腕部创伤26例,根据缺损部位、大小及形状,6例以桡骨茎突上6 cm为轴点(位于肱桡肌腱外侧),8例以桡骨茎突上2 cm为轴点和桡动脉的体表投影线为轴心线,12例以鼻烟窝中点为轴点,桡骨茎突至桡骨小头的连线为轴心线,分别设计面积最大10 cm×8 cm,最小4 cm×3 cm的皮瓣。结果 3例皮瓣远端浅表坏死,经换药后愈合,其余23例完全成活,随访6个月,手及腕部外形和功能良好。结论桡动脉穿支逆行皮瓣血供可靠,操作简单,不损伤主要血管,术后手及腕部外形和功能恢复良好,是一种较理想的修复方法。

Objective To evaluate the clinical curative effect of radial artery perforator reverse flap was utilized to repair the defect in hand and wrist .Methods From June 2007 to June 2014, 26 patients with defect in hand and wrist were treated with radial artery perforator reverse flap .According to the site , size and shape of defect , 6 cm above the radial styloid process as pivot point in 6 cases, located laterally to the tendon brachioradialis .Pivot point of the flap at 2 cm above the radial styloid process in 8 cases with body surface projection of radial artery as axial line .Midpoint of nasopharyngeal fossa as pivot point in 12 cases with axial line from ra-dial styloid process to radial head .The biggest flap at 10 cm ×8 cm and the smallest flap at 4 cm ×3 cm were designed .Results 23 flaps completely survived, distal necrosis was seen in 3 flaps which healed by changing dressings .Followed up for 6 months, the func-tion and appearance of hand and wrist were satisfying .Conclusions The radial artery perforator reverse flap is an ideal method for re-pairing the defect in hand and wrist due to its reliable and convenient qualities , no damage to the main blood vessel and acquiring a sat-isfied recovery of appearance and function .