桡动脉蒂联体穿支游离皮瓣修复手指跨节长条形皮肤软组织缺损

Radial artery pedigreed conjoined perforator flap repair cross-joint long-shaped skin and soft tissue defects in fingers

目的探讨桡动脉蒂联体穿支游离皮瓣修复手指跨节长条形皮肤软组织缺损的方法及临床疗效。方法自2015年6月至2017年6月．对于6例手指跨节长条形皮肤软组织缺损修复．以桡动脉的体表走行线为轴线设计皮瓣，皮瓣包含2条桡动脉穿支．增加了皮瓣的切取范围。皮瓣切取面积为3．0cm×6．0cm．3．5cm×7．5cm，皮瓣供区均直接缝合。术后随访3～8个月，观察皮瓣的外观、质地、感觉、活动功能及供区情况。结果6例皮瓣全部成活，伤151均I期愈合，全部患者获得随访，术后3～8个月随访，平均5个月，皮瓣无明显臃肿．质地柔软，色泽正常，与受区相似。供区愈合良好．仅留线型瘢痕。结论应用桡动脉蒂联体穿支游离皮瓣修复手指跨节长条形皮肤软组织缺损，增加了皮瓣切取范围，且切取方便，质地与受区接近．是一种较理想修复方法。

Objective To explore the method and clinical effect of radial artery pedigreed conjoined perfora- tor flap for repairing cross-jolnt long-shaped skin and soft tissue defects in fingers. Methods From Jtme, 2015 to June, 2017, six patients with cross-joint long-shaped skin and soft tissue defects of the fingers were treated with radial artery pedigreed conjoined flap which axis was the artery superficial line, and carried two radial artery perforators, in order to enlarge flap cut range to repair. The size of flaps ranged from 3.0 cm x 6.0 cm to 3.5 cmx 7.5 cm. The donor site was directly sutured. After operation, all patients were followed up for 3 to 8 months. All the necessary parts are observed, such as the flaps appearances, textures, the donor sites, checked the flap sensation, activity functions of the fingers. Results Six cases of flap all survived. The wounds healed well （phase I）, and all patients were followed up for 3 to 8 months, with an average of 5 months. All the flaps do not obviously bloat, the textures were soft,the colors are normal, the appearances of flaps were similar to recipient sites. The donor sites healed well only with linear scars. Conclusion Using radial artery pedigreed conjoined perforator flap to repair cross-joint long-shaped skins and soft tissue defects in fingers that it not only can enlarge the cut range but also cut conveniently, the textures are close to recipient sites .Therefore, it is an ideal repair way.