拇指桡侧指固有血管穿支为蒂的桡背侧皮瓣修复拇指皮肤软组织缺损

Reconstruction of thumb soft tissue defect by homodigital artery perforator-based dorsal radial flap

目的探讨拇指桡侧指固有血管穿支为蒂的桡背侧皮瓣修复拇指皮肤软组织缺损的临床效果。方法对2014年1月至2016年1月收治的8例拇指皮肤软组织缺损患者,采用拇指桡侧指固有血管穿支为蒂的桡背侧皮瓣进行修复,切取皮瓣面积为2.0 cm×1.5 cm^3.0 cm×2.5 cm,供区直接缝合或应用断层皮肤覆盖。结果术后8例拇指桡侧指固有血管穿支为蒂的桡背侧皮瓣均成活。随访1~18个月,皮瓣色泽、质地、外形良好,软组织缺损区及供区形态与功能修复良好。结论采用拇指桡侧指固有血管穿支为蒂的桡背侧皮瓣修复拇指皮肤软组织缺损,是一种可靠、实用的修复方法。因其皮瓣血供可靠,移动度充足,术中操作要点简明,不牺牲重要血管,无须吻合血管及蒂部复杂的解剖,缩短了手术时间,减少了术中创伤,具有临床应用的推广价值。

Objective To explore the clinical application of the versatile homodigital artery perforator-based dorsal radial flap for resurfacing thumb soft tissue defects.Methods Between January 2014 and January 2016,8 cases with thumb soft tissue defects were repaired by homodigital artery perforator-based dorsal radial flap.The incision area of the flaps ranged from 2.0 cm×1.5 cm to 3.0 cm×2.5 cm.The donor site was directly sutured or covered with a split-thickness skin graft.Results All flaps survived completely.The results were satisfactory,both aesthetically and functionally.Conclusion This method is reliable and practical for repairing defects of the thumb soft tissue.The advantages of this flap are its ease and speed of dissection-hence saving operation time-minimal morbidity of the donor site,preservation of major arteries,and prevention of vascular anastomosis.It should be considered for promotion in clinic.