食指背皮瓣修复拇指皮肤软组织缺损的临床应用

Clinical Application of Using the Index Dorsal Flap to Repair Thumb Defects

目的：总结应用食指背皮瓣修复拇指损伤后皮肤软组织缺损的效果。方法以第一掌背动脉为皮瓣供血，在食指近节指背切取皮瓣。取食指桡侧侧中线的延长线为轴线，以拇长伸肌腱与第2掌骨交点为旋转点，保留2．5～3．0cm宽筋膜皮蒂。皮瓣携带指背神经与受区神经断端进行缝合修复，重建手指感觉。自2011年～2013年共对38例拇指机器伤后组织缺损患者进行清创，进行食指背岛状皮瓣修复，观察治疗效果。结果38例皮瓣全部成活，创面均Ⅰ期愈合。术后6个月～1年的随访，皮瓣外形与正常相近，色泽、弹性良好。受区饱满而不臃肿，两点辨别觉达5～9mm。结论采用食指背皮瓣修复拇指组织缺损，操作简单，疗程短，术后并发症少，并且能重建皮瓣感觉，是修复拇指组织缺损的理想方法。

[ ABSTRACT] Objective To explore the operative technique and clinical results of using an island flap from the dorsum of the index finger to repair thumb defects .Methods This flap was based on the first dorsal metacarpal artery ,and tailored on the dorsum of the index of proximal phalanx .Thirty-eight patients with skin and soft tissue defects of thumb from 2011 to 2013 were repaired with the island flaps from the dorsum of the index finger ,and their treatment effects were observed .Results All flaps achieved primary healing .Patients were followed up for 6 months to 1 year,the color of flap skin and texture were closed to normal .The sensory were recovered ,the static two-point discrimina-tion was 5~9mm.Conclusion Because of its simple operation ,short course and less postoperative complications ,the island flap from the dorsum of the index finger is a reliable option to cover soft tissue defects of distal thumb , offering acceptable functional and cosmetic out-comes.