不带筋膜组织的逆行指动脉皮瓣修复指端创面

目的探讨不带筋膜的逆行指动脉岛状皮瓣修复指端创面的疗效.方法2017年6月至2020年3月采用逆行指动脉岛状皮瓣修复30例(36指)指端缺损创面,皮瓣血管蒂部不带筋膜组织,且不携带指固有神经.手指指端创面缺损面积1.5cm×1.6cm^2.5cm×3cm,平均2cm×2.2cm,切取皮瓣时皮瓣面积较创面大约10%,皮瓣供区先予以皮下组织覆盖裸露指神经,后行腋窝全厚皮片移植修复.结果术后皮瓣及移植皮片全部成活,静脉危象出现3例,术后回访时间1~12个月,其中10例患者于3个月后失访,20例24指获得良好的随访,皮瓣外形恢复满意,质地耐磨,两点分辨觉7~12mm,平均9mm,皮瓣外形及功能佳.结论不带筋膜组织的逆行指动脉岛状皮瓣具有蒂部不易卡压、组织损伤小、皮瓣成活率高及质地优良等优点,是修复指端缺损的一种良好手术方法,具有较好的临床应用价值.

Objective To explore the therapeutic efct of dect on finger skin with reverse digital artery flap without fascia tsse.Methods From June 2017 to March 2020,the reverse digital artery island flap without fascia tssue and nervous tsse were used to repair the finger defect of 36 fingers in 30 cases.The defect size ranged from 1.5cmx 1.6cm to 2.5cm x 3cm,with an average size of 2cm x 2.2cm.The flap size was 10%larger than the defect size.Using subcutaneous tssue to cover the exposed finger nerve,Full-thickness skin from Axilla was used to repair the flap donor site.Results All the flaps and skin gafts were survived,3 patients occurred venous crisis,20 patients(24 fingers)were fllowed up 1 monthto I year.The two-point discrimination was between7 and 12mm,average of which was 9mm.The flap had good shape and fiunction.Conclusion The reverse digital artery island flap without facial tssue has many advantages,such as dificult compression of the pedicle,small tssue damage,good survival rate and texture,which is a kind of sungical method for repairing finger tip defect with good clinical efect.