吻合静脉的指背旗帜状皮瓣修复邻指近节皮肤撕脱伤

Dorsal kite flap transfer from the adjacent finger for coverage of skin avulsion of the proximal phalanx

目的探讨吻合静脉的指背旗帜状皮瓣修复邻指近节皮肤撕脱伤的临床疗效。方法自2012年3月至2014年2月，我们采用吻合静脉的指背旗帜状皮瓣修复邻指近节皮肤撕脱伤9例，切取皮瓣范围为1．8cm×1．8cm～2．2cm×3．2cm。供区取前臂全厚皮片植皮修复。结果术后9例患者伤口均Ⅰ期愈合，指背皮瓣均无肿胀，皮瓣及近节撕脱的皮肤顺利存活。术后所有患者均获得随访，时间为6～24个月。患指血运可，皮瓣质地软、弹性好、耐磨，根据中华医学会手外科学会断指再植功能评定试用标准评定：优7例，良1例，可1例。结论采用吻合静脉的指背旗帜状皮瓣修复邻指近节皮肤撕脱伤能一期修复创面，最大程度恢复患指的外形和功能。

Objective To evaluate the clinical results of dorsal kite flap transfer with vein anastomosis for treatment of proximal avulsion injury of the adjacent finger. Methods From March 2012 to February 2014 defects of the proximal finger caused by avulsion injury in 9 patients were repaired by transferring a dorsal kite flap from the adjacent finger. The superficial vein in the flap was anastomosed with the severed digital artery to establish flow-through perfusion. The size of the flaps ranged from 1.8 cm× 1.8 cm to 2.2 cm× 3.2 cm. The donor site was covered with full thickness skin graft from the forearm. Results Primary wound healing was achieved in all 9 cases. The dorsal flaps and skin grafts all completely survived. No flap swelling was noted. The patients were foflow-up for 6 mouths to 2 years postoperatively. Peffusion of the affected fingers was good. The flaps were soft and durable. Based on functional evaluation criteria for finger replantation issued by the Hand Surgery Society of the Chinese Medical Association, the results were excellent in 7 cases, good in 1 case, and fair in 1 case. Conclusion Dorsal kite flap transfer with vein anastomosis can repair proximal avulsion injury of the adjacent finger and maximize recovery of the function and appearance of the fingers.