携带神经的示指桡侧指背动脉逆行岛状皮瓣重建示指外形及感觉

Reconstruction of shape and sensation of index finger with tretrograde island flap of radial dorsal digital artery with nerve

目的探讨携带神经的示指桡侧指背动脉逆行岛状皮瓣重建手指外形及感觉的临床效果。方法选取2015年1月-2018年5月收治的54例示指皮肤软组织缺损患者的临床资料,其中采用携带神经的示指桡侧指背动脉逆行岛状皮瓣修复(A组),随意腹部皮瓣修复(B组),及采用手外伤"V-Y"推进皮瓣修复(C组)各18例。对入选患者进行随访,对术后指腹综合质地感觉、手指总主动活动度(TAM)、皮肤感觉恢复情况、皮瓣两点辨别觉(2 PD)等指标进行比较。结果术后54例皮瓣全部成活,A组修复后在皮肤色泽、质地、外形上较为满意,指腹综合质地感觉优于B、C两组(P <0.05);在皮瓣感觉恢复、TAM、2 PD等指标上,A组均好于B、C两组,差异有统计学意义(P <0.05)。结论携带神经的示指桡侧指背动脉逆行岛状皮瓣修复示指皮肤软组织缺损在综合质地感觉、感觉恢复情况、两点辨别觉等方面具有优势,是较为理想的修复术式。

Objective To investigate the effect of reconstruction of shape and sensation of index finger with retrograde island flap of radial dorsal digital artery with nerve. Methods The clinical data of 54 patients with soft tissue defect admitted to our hospital from January 2015 to May 2018 was collected.Among them, 18 cases were repaired with radial dorsal digital artery retrograde island flap(group A), 18 cases with random abdominal flap(group B) and 18 cases with hand trauma "V-Y" advanced flap(group C). The selected patients were followed up after surgery, and the comprehensive texture sensation of finger pulp, total active motion of fingers(TAM), skin sensory recovery, two-point discrimination of skin flap(2PD) were compared. Results In group A, the skin color, texture and appearance were satisfactory;and the comprehensive texture sensation of pulp, the sensory recovery of skin flap, TAM and 2PD were better than those in group B and C(P <0.05). Conclusion The reconstruction of shape and sensation of index finger with soft tissue defect of radial dorsal digital artery has advantages in comprehensive texture sensation, sensory recovery and two-point discrimination. It is an ideal method to repair index finger soft tissue defect.