仅吻合动脉的桡动脉掌浅支皮瓣修复手指指端缺损

Superficial palmar branch of radial artery flap with a single arterial anastomosisin for the repair of fingertip defects

目的探讨仅吻合动脉的桡动脉掌浅支皮瓣在修复手指指端缺损中的疗效和可行性。方法自2018年6月至2019年12月,海军第九七一医院手外科对10例指端缺损面积<2.0 cm×2.5 cm的患者行桡动脉掌浅支皮瓣修复,末节无可供吻合的静脉,单纯吻合掌浅支与指动脉;术后应用肝素静脉推注5~7 d,皮瓣边缘自然渗血,一般术后3~5 d渗血明显减少。术后1~12个月(平均6个月)通过门诊复查及电话、微信方式随访。结果10例皮瓣均一期成活,皮瓣外形满意,质地柔软,色泽与受区接近,且患指未留额外瘢痕。结论单纯吻合动脉的桡动脉掌浅支皮瓣手术操作简单,且缩短了手术时间,降低了手术难度,为无可供吻合静脉的指端缺损患者提供了一种可选择的游离皮瓣修复方法。

Objective To explore the curative effect and feasibility of superficial palmar branch of radial artery flap with a single arterial anastomosis in the repair of fingertip defects.Methods From June 2018 to December 2019,10 patients with fingertip defects were repaired by superficial palmar branch of radial artery flap.The area of defects were less than 2.0 cm×2.5 cm.There were not suitable veins to anastomose at distal finger.The vascular anastomosis was only made between the superficial palmar branch of radial artery and the digital artery.The heparin was injected intravenously for 5 to 7 days after operation.The blood seepage occurred at the edge of flap and significantly reduced at 3 to 5 days after operation.The follow up through outpatient review,telephone and We Chat ranged from 1 to 12 months,with an average of 6 months.Results All flaps survived completely.The appearance was satisfactory,the texture was soft and the color was close to the recipient site.No extra scars occurred in the injury fingers.Conclusion The superficial palmar branch of radial artery flap with a single arterial anastomosis is simple to operate.The operation duration is shortened and the difficulty is reduced.The superficial palmar branch of radial artery flap with a single arterial anastomosis provide a choice for fingertip defects without anastomotic veins.