跖背动脉穿支皮瓣修复趾甲瓣供区的临床应用

The clinical effect of using dorsal plantar artery perforators flap for repairing toenail flap donor area wound

目的 探讨利用跖背动脉穿支皮瓣修复趾甲瓣供区创面的临床疗效.方法 2006年4月-2014年10月,收治外伤致手指甲床及周围皮肤软组织缺损、骨外露患者20例,均采用趾甲瓣趾-指动脉吻合修复,供区应用跖背动脉穿支皮瓣修复踇甲瓣供区8例、 第2趾甲瓣供区10例、 第3趾甲瓣供区2例.供区缺损面积：1.5 cm×2.0 cm^2.5 cm×3.5 cm,皮瓣切取面积：2.0 cm×2.5 cm^3.0 cm×4.0 cm.结果 20例皮瓣全部成活,术后2例出现张力性水疱,蒂部经间断拆线、换药后,张力性水疱消失,供区植皮全部成活.随访12~36个月,皮瓣色泽、质地、弹性良好,皮瓣无溃疡,愈合良好,外观满意,趾体屈伸活动及足部行走良好.结论 应用跖背动脉穿支皮瓣修复趾甲瓣供区创面,不牺牲主干血管,成活率高,切取简单、方便,外形满意,是修复趾甲瓣供区创面的理想方法.

Objective To explore the clinical effect of using dorsal plantar artery perforators flap for repairing toenail flap donor area wound. Methods From April 2006 to October 2014, we treated 20 cases with toe nail bed and surrounding skin soft tissue defect, and bone exposed, using toe-artery anastomosis of toenail flap. The restore of donor area, using plantar artery perforators flap repair wound of toenail flap area in 8 cases, 10 cases of the second toenail flap area, the third toenail flap area in 2 cases. Area for the defect in the area was 1.5 cm×2.0 cm^2.5 cm×3.5 cm, the flap area was 2.0 cm×2.5 cm^3.0 cm×4.0 cm. Results 20 cases flaps all survived. 2 cases occured tension blister after surgery, through taking out stitches of pedicle and dressing, tension blister disappear, all grafting skin of donor area survived after 12 to 36 months. Flap color, texture, flexibility was good, the flap without ulcers, healed perfectly, satisfactory appearance, toe body flexion and extension function and walking were normal. Conclusion Use the dorsal plantars artery perforator flap for repairing toenail flap donor area, without sacrificing the trunk blood vessels, high survival rate, simple and convenient, satisfactory appearance, was an ideal method for repairing toenail flap donor area wound.