游离桡动脉掌浅支腕横纹皮瓣修复指背皮肤缺损的临床观察

Clinical Observation on Free Superficial Palmar Branch of Radial Artery andWrist Transverse Striated Skin Flap for Repair of Skin Defect of Finger Back

目的探讨游离桡动脉掌浅支腕横纹皮瓣修复指背皮肤缺损的临床效果。方法选取2018年1月至2019年10月中铁二局集团第二医院收治的36例指背皮肤缺损患者,采用随机数字表法分为试验组(游离桡动脉掌浅支腕横纹皮瓣修复,17例)和对照组(全厚皮片或带蒂掌背皮瓣修复,19例)。统计两组手术时间,观察皮瓣存活情况,随访评价皮瓣外形、知觉与手功能恢复情况,统计治疗满意度。结果两组皮瓣均成活,移植成功率均为100%。试验组术后受区皮瓣颜色和质地均与周围皮肤接近,外形美观,指功能正常,效果优于对照组。两组手术时间相似,差异无统计学意义(P>0.05)。结论以游离桡动脉掌浅支腕横纹皮瓣修复指背皮肤缺损,术后皮瓣成活率高,外形美观度高,手功能恢复好,效果确切,安全可靠,可作为指背皮肤缺损首选修复方法。

Objective To investigate the clinical effect of free wrist transverse flap with superficial palmar branch of radial artery in repairing skin defect of dorsal finger.Methods From January 2018 to October 2019,38 patients with dorsal digital skin defect in the Second Hospital of China Railway Second Bureau Group were selected and divided into experimental group(free superficial palmar branch of radial artery wrist cross striated flap repair,17 cases)and control group(full thickness skin flap or pedicled dorsal metacarpal flap repair,19 cases).The operation time of the two groups was counted,the survival of the flaps was observed,the shape,perception and hand function recovery of the flaps were followed up,and the treatment satisfaction was counted.Results Both flaps survived and the success rate of transplantation was 100%.The color and texture of the skin flap in the experimental group were similar to those of the surrounding skin,with beautiful appearance and normal finger function.The operation time of the two groups was similar There was no statistical difference (P>0.05). Conclusion The flap with free superficial palmar branch of radial artery is safe and reliablein repairing dorsal finger skin defect. The flap has high survival rate,high appearance,good recovery of handfunction,exact effect,safety and reliability. It can be used as the preferred repair method for finger backskin defect.