改良短蒂双供血跗外侧皮瓣修复手指软组织缺损

The modified lateral tarsal flap with the double arterial system transfer for repairment of skin defects of fingers

目的 探讨利用短蒂外踝前动脉及跗外侧动脉双供血的跗外侧皮瓣修复手指软组织缺损的临床疗效.方法 2014年3月-2015年8月,对7例手指软组织缺损伴一侧指动脉断裂并缺损者,采用短蒂外踝前动脉及跗外侧动脉双供血的跗外侧皮瓣修复,指动脉远近断端分别与外踝前动脉及跗外侧动脉吻合.结果 游离跗外侧皮瓣全部成活,供受区均Ⅰ期愈合.术后随访1~6个月.受区皮瓣外观良好,供区无功能障碍.结论 手指软组织缺损伴一侧指动脉断裂并缺损者,采用短蒂外踝前动脉及跗外侧动脉双供血的跗外侧皮瓣修复,可修复缺损指动脉,增大皮瓣切取面积,短蒂减少供区肌腱腱膜损伤,植皮成功率高,疗效满意.

Objective To explore the clinical efficacy of repairing finger skin defect by the free lateral tarsal flap based on the lateral anterior malleolar artery and lateral tarsal artery, wihch has the double arterial system and short vascular pedicle. Methods Between March 2014 and August 2015, the free lateral tarsal flap based on the lateral anterior malleolar artery and lateral tarsal artery was carried out to repair the soft tissue and blood vessel defect. The blood of the flap has the double arterial system and short vascular pedicle, vascular anastomosis was in the way of the proximal of digital artery to lateral tarsal artery, and the distal of digital artery to the lateral anterior malleolar artery. Results All the free lateral tarsal flaps survived. All the recipient site and the donor site were primary healing, the follow-up time was 1 to 6 months. The flaps showed good appearance, The function of the donor site was not affected. Conclusion The free lateral tarsal flap based on the lateral anterior malleolar artery and lateral tarsal artery is carried out to repair the soft tissue and blood vessel defect of finger, and to increase the area of flap, the double arterial system of the flap is used to repair the defect of the artery, the short vascular pedicle in the flap can reduce the damage of tendon membrane in donor site, skin-grafting can obtain high success rate, the effect is satisfactory.