指背神经筋膜蒂皮瓣供区应用掌指背V－Y推进皮瓣修复的研究

A study of the dorsal pahn-finger V-Y advancement flap to reconstruct the donor site of fasciocutaneous flap pedicled dorsal digital nerves

目的探讨应用指背神经筋膜蒂皮瓣修复指端皮肤软组织缺损，皮瓣供区应用掌指背V－Y推进皮瓣修复的临床效果。方法2012年1月至2013年12月，设计应用指背神经筋膜蒂皮瓣修复指端皮肤软组织缺损患者13例，男8例，女5例；年龄18～55岁，平均38．5岁。皮瓣供区均采用掌指背V－Y推进皮瓣修复。结果本组13块指背神经筋膜蒂皮瓣及掌指背V－Y推进皮瓣全部存活。术后随访3个月至2年，平均15个月，指背神经筋膜蒂皮瓣外形及感觉恢复良好，供区掌指背皮瓣质地优良，无明显瘢痕增生，感觉恢复良好，指蹼无挛缩，伤指功能恢复满意。结论应用指背神经筋膜蒂皮瓣修复指端皮肤软组织缺损，皮瓣供区应用掌指背V－Y推进皮瓣修复，获得较好的临床效果，与传统供区植皮术式相比，能有效避免供区植皮凹陷、瘢痕增生及植皮坏死等并发症。

Objective To investigate the treatment of the dorsal palm-finger V-Y advanced pedicled flap with dorsal digital nerves to repair finger pulp defect. Methods From January 2012 to December 2013, 13 patients （8 males and 5 females） with fingertip skin defects were treated with dorsal palm-finger V-Y advanced pedicled flap. The patients aged from 18 to 55, with an average of 38.5. Results All flaps survived. These cases were follow-up for 3 to 24 months postoperatively, 15 months on average. All pedicled fasciocutaneous flaps with dorsal digital nerves got satisfactory appearance and recovered good sensory function. The character and sensory function of dorsal palm-finger V-Y advanced flap was good. No obvious scar hyperplasia or web contracture was seen. Condusion Application of the dorsal palm-finger V-Y advanced pedicled flap with dorsal digital nerves to repair finger pulp defect could achieve good clinical effect. Compared with traditional skin grafting, it could avoid the complications such as skin graft depression, scar hyperplasia, skin graft necrosis and so on.