足背超薄静脉皮瓣游离修复手指软组织缺损

Application of free super-thin venous skin flap of dorsal foot for repair of soft tissue defects of finger

目的探讨使用足背超薄静脉皮瓣游离修复手指软组织缺损的临床疗效。方法自2017年1月至2018年1月收治14例外伤致手指软组织缺损患者,按手指缺损面积于足背切取超薄静脉皮瓣,静脉动脉化游离修复创面,后4例在切取时附带足背皮神经。供区均直接缝合。术后手部石膏外固定2周后开始功能锻炼。结果术后随访6-12个月,11例顺利存活,2例皮瓣发生部分坏死,1例3个月后失访。部分坏死病例经过换药后愈合。前10例两点分辨觉11-13 mm,后4例带神经两点分辨觉7~9mm.结论应用足背超薄静脉皮瓣游离修复手指组织缺损操作简便,外观满意,供区可宜接缝合,带足背神经切取可同时重建感觉功能。

Objective To explore the clinical efficacy of free super-thin venous skin flap of dorsal foot for repair of soft tissue defects of finger.Methods From January 2017 to January 2018,14 patients with soft tissue defect of finger were treated.The super-thin venous flaps were harvested from the dorsal foot according to the area of finger defects.The wound was repaired by arterialization of veins.The dorsal cutaneous nerve of foot was incised in 4 cases.The donor site was sutured directly.The functional exercises were started after 2 weeks of immobilization.Results All the patients were follow-up for 6 to 12 months,11 cases survived uneventfully,2 cases had partial necrosis of skin flaps,and 1 case lost follow-up after 3 months.The partial necrosis of skin flaps healed after dressing change.10 cases had twopoint discrimination of 11 to 13 mm,and 4 cases with nerve in flaps had two-point discrimination of 7 to 9 mm.Conclusion It is simple and satisfactory to repair finger tissue defects with super-thin venous skin flap of dorsal foot.The donor site can be sutured directly and the sensory function can be reconstructed simultaneously with dorsal foot nerve excision.