游离足内侧皮瓣在复杂手部皮肤缺损中的应用

Application of free medial plantar flap in the reconstruction of complex hand skin defects

目的观察足内侧皮瓣修复手部缺损的效果。方法对复杂手部缺损患者，体表标记足内侧皮瓣的形状及大小，解剖出供养皮肤动静脉，游离移植于手部与受区血管吻合。结果本组共11例患者，术后皮瓣全部成活。术后平均随访3个月，皮瓣质地柔软。臃肿的皮瓣一般在术后3～6个月逐渐平整。结论足内侧皮瓣供区隐蔽，创伤小，皮肤质地与手掌及指腹相似，是修复复杂手部皮肤缺损的理想选择。

Objective To explore the effect of free medial plantar flap on the reconstruction of complex skin defects of the hand. Methods For 11 eases with complex skin defects of the hand, reconstruction was performed by marking the shape and size of free medial plantar flap, dissecting the nourishing arteries and veins of the flap. These were then grafted to the defect to create vascular anastomosis. Results All flaps survived completely on 11 cases. By an average three month follow-up, the transferred flaps were soft, and the swollen flaps became more smooth at 3 to 6 months. Conclusion For complex skin defects, free medial plantar flap was the ideal choice with these advantages： concealed donor area, tiny wound, and similar texture to that of palm and finger pulp.