桡动脉掌浅支腕横纹Flow-through皮瓣修复手指皮肤软组织缺损

Repair of digital skin soft tissue deffect by transverse carpal flow-through flap with superficial palmar branch of radial artery

目的应用桡动脉掌浅支腕横纹Flow-through皮瓣修复手指皮肤软组织缺损伴指动脉缺损创面,更好恢复手指生理供血,提高临床疗效。方法2008年8月-2018年10月,对收治的48例手指皮肤软组织缺损伴指动脉缺损患者,切取桡动脉掌浅支腕横纹Flow-through皮瓣覆盖手指缺损创面,让创伤缺损动脉恢复再通血;供区直接缝合。结果术后皮瓣全部成活,创面Ⅰ期愈合,48例均获得随访,随访时间32~48周,平均40周,末次随访时皮瓣质地柔软,指体外观无臃肿,颜色与患指周围皮肤相似,皮瓣两点辨别觉6~12 mm,手指功能根据总主动活动度(TAM)法评定,优45例,良2例,可1例,优良率97.9%。结论手指皮肤软组织缺损伴动脉缺损,影响指端供血,应用桡动脉掌浅支腕横纹Floe-through皮瓣修复,巧妙桥接指动脉缺损,更好地恢复手指生理血供。

Objective To apply the radial artery superficial palm branch wrist flow-through flap to repair finger skin soft tissue defect with finger artery defect to better restore finger physiological blood supply,and improve the clinical effect.Methods Fourty-eight patients with finger skin and soft tissue defects accompanied by finger artery defects were admitted to our hospital from August 2008 to October 2018.Among all patients,40 were male and 8 were female,aged from 18 to 65 years old,with an average age of 42 years old.There were 35 cases of right hand and 13 cases of left hand.The superficial palm branch of radial artery was cut and the transversal carpal flap was used to cover the finger defect wound surface,allowing the injured artery to restore blood circulation and the donor area was directly sutured.Results All flaps survived and the wound healed in the first stage.All 48 patients were followed up for 32 weeks-48 weeks,with an average of 40 weeks.At the time of the last follow-up,the flap texture was soft,the fingers were not swelling,and the finger color was similar to the surrounding skin.Two discrimination points of the flap was 6-12 mm,and finger function was evaluated by total active activity(TAM)method.The result was excellent in 45 patients,good in 2 patients,and acceptable in 1 patient,with an excellent and good rate of 97.9%.Conclusion The skin and soft tissue defect of finger is accompanied by the absence of artery,which affects the blood supply at the finger end.The superficial palm branch of radial artery is applied to repair the wound with the floe-through flap,which ingeniously bridges the finger artery defect,and can better restores the physiological blood supply of fingers.