指动脉顺行V-Y岛状皮瓣修复指腹缺损

Repair of digital pulp defect by digital arterial anterograde V-Y island flap

目的评价指动脉顺行"V-Y"岛状皮瓣修复手指指腹缺损的临床疗效。方法2015年3月-2018年6月,应用指动脉顺行"V-Y"岛状皮瓣修复手指指腹缺损20例,均有末节指骨外露,缺损面积最小1.0 cm×1.0 cm,最大1.5 cm×1.5 cm,供区均直接闭合。结果20例皮瓣全部成活,皮瓣及手指外形满意。随访3~6个月,平均4.5个月,两点辨别觉3~5 mm。指间关节屈曲活动18例均无明显受限,2例因手指屈曲位缝合皮瓣,出现手指远指间关节屈伸轻度受限。按TAM法评定标准评定:优良率90%。结论顺行指动脉"V-Y"岛状皮瓣手术操作不仅简单,同时内含血管神经束,血供稳定,感觉恢复良好,能够恢复良好的手指外形和功能,是修复指腹缺损的比较理想的手术方式之一。

Objective To evaluate the clinical effect of anterograde V-Y island flaps on repairing the defect of finger pulp.Methods From March 2015 to June 2018,20 cases with defect of finger pulp were repaired with anterograde V-Y island flap of digital artery,All of which had distal plalanx exposure.The minimum defect area was 1.0 cm×1.0 cm,and the maximum was 1.5 cm×1.5 cm.The donor area was closed directly.Results All flaps survived with satisfactory appearance of both flaps and fingers.The time of follow-up was 3-6 months,with an average of 4.5 months.The two-point discrimination examination was 3-5 mm.The flexion of the interphalangeal joint were not significantly limited in 18 cases,and there was mild limitation of distal interphalageal joint flexion in 2 cases due to the flexion of finger when suturing the flaps.According to TAM evaluation standard,the excellent and good rate was90%.Conclusion Anterograde digital artery V-Y island flap is not only easy to operate,but also contains vascular and nerve bundles,with stable blood supply,good feeling recovery,good-looking and finger function,is one of the ideal surgical method for repairing the finger pulp.