指动脉中节指背穿支血管链逆行岛状皮瓣修复指端缺损

In the section of dorsal finger artery perforator chain flap to repair finger tip defect

目的探讨应用指动脉中节指背穿支血管链逆行岛状皮瓣修复手指指端软组织缺损的临床疗效。方法2012年1月-2014年3月，分别应用食、中、环、小指指动脉中节指背穿支血管链逆行岛状皮瓣修复指端组织缺损33例，皮瓣切取面积1．0cm×l．3cm～1．9cm×2．6cm。结果27例皮瓣顺利成活：1例因术后感染，皮瓣坏死，患者选择行残端修整治疗；2例术后第2天因蒂部肿胀卡压呈暗红色．拆除蒂部缝线后好转；3例皮瓣远端出现少许坏死，经12d换药后愈合。28例获得随访，时间6～20个月．获得随访皮瓣外形美观，色泽正常，指端饱满，无臃肿、挛缩畸形，无触压痛，感觉、功能恢复良好。参照手功能TAM法测定：优23例，良3例，可2例，优良率达92．8％。结论指动脉中节指背穿支血管链逆行岛状皮瓣具有手术操作简便，供区损伤小，术后外形、感觉、功能恢复良好，患者易接受。易于在基层医院开展等优点。

Objective To ivestigate the clinical effect of application of digital artery in dorsal perforator chain retrograde island flap in repairing finger soft tissue defects in the end. Methods From January 2012 to March 2014, we repaired 33 cases wound that the index finger, middle, ring and little finger by using the section of dorsal finger artery perforator chain flap for repairing finger tip defect. The maximum area of flaps is 2.6 cm×1.9 cm,the minimum is 1.3cm×1.0cm. Results 27 cases of flaps survived and 1 case because of postoperative infection, had necrosis, patient selection for stump dressing treatment, 2 cases on the second postoperative day due to swelling card pressure is dark red, after pedicle suture removal improvement, occured 3 cases had a little necrosis in the distant edge of the flaps, after 12 days after dressing change for healing. 28 cases of them received follow-up from 6 to 20 months, follow-up flap appearance, normal color refers to end full, no fat, contracture, no tenderness, feel and function recovered well. Evaluating by the hand function TAM： 23 patients reached to the excellent level, 3 patients reached to the better level and 2 reached to the good level, the excellent and good rate was 92.8%. Conclusion Refer to section in the arteries that dorsal perforator vessel chain of retrograde island flap has the advantages of simple operation, little damage, postoperative appearance, sensation and function recovered well, easily accepted by patients, easy to in grass-roots hospitals to carry out the promotion of the advantages.