带蒂桡动脉掌浅支腕横纹部皮瓣在拇指创面修复中的应用

Application of a pedicled wrist crease flap based on the superficial palmar branch of the radial artery （SPBRA）for thumb reconstruction

目的探讨利用带蒂桡动脉掌浅支腕横纹部皮瓣在拇指创面修复中的应用方法及临床疗效。方法2012年1月-2013年10月，收治9例拇指软组织缺损患者，软组织缺损范围3．0cm×1．3cm～6．3cm×2．0cm。8例采用SPBRA腕横纹岛状皮瓣带蒂逆行转移修复拇指软组织缺损，供区直接缝合。结果除1例因血管蒂变异改变术式外，余手术均顺利完成。术后皮瓣全部成活，供区切口均Ⅰ期愈合。术后随访4-14个月，皮瓣质地外形满意，供区无明显瘢痕，患指功能按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7例，良1例，可1例，优良率88．9％。结论带蒂桡动脉掌浅支腕横纹部皮瓣血运可靠、手术简便．是修复拇指软组织缺损创面较理想方法。

Objective To investigate the chnical effect of using the superficial palmar branch of radial artery pedicled flap in wrist crease on thumb wound repair. Methods 2012.1-2013.10 in our hospi- tal 9 cases of thumb soft tissue defects, with soft tissue defects of 3.0 cm×l.3 cm×6.3 cm×2.0 cm, were treated with the size of 1.5cm×3.5cm×3.0 cm7.0 cm SPBR.A wrist crease island flap pedicled with retrograde SPBRA flap, the donor sites were sutured directly. Results Except for 1 case be- cause of vascular pedicle variation changeed operation type, other operations were successfully com- pleted. All flaps survived after operation, the donor site wound healed in one stage. Patients were followed up for 4~14 months, the texture of the flap was satisfactory, for the region without obvi- ous scar, injured finger function according to the Chinese Medical Association of hand surgery to the upper extremity functional evaluation standard： the results were excellent in 7 cases, good in 1 case, the excellent and good rate was 88.9%. Conclusion The superficial palmar branch of radial artery wrist crease flap with rehable blood supply, and has the advantages of simple operation, is an ideal method for repairing the thumb soft tissue defect.