游离前臂静脉皮瓣修复手指掌侧皮肤缺损

Repair of digital palmar skin defect by free forearm venous flap

目的探讨应用同侧前臂静脉皮瓣急诊一期修复手部皮肤缺损的手术方式和临床疗效。方法2015年8月-2018年8月,对13例手部掌侧皮肤缺损患者,急诊一期游离移植前臂静脉皮瓣修复创面,供区直接缝合,定期随访。结果12例皮瓣成活,1例坏死。12例成活皮瓣中,4例顺利成活,外观和质量接近生理皮瓣;6例出现轻中度肿胀、瘀血、水疱,经及时处理后,顺利成活,伴有不同程度色素沉着;2例皮瓣部分坏死,换药愈合。结论应用同侧前臂游离静脉皮瓣修复手部掌侧皮肤缺损,皮瓣切取方便,成活率高,可一期修复创面,同时修复血管、肌腱的缺损,不损伤知名动脉,术后外形满意。

Objective To explore the surgical method and clinical effect of the first-stage emergency repair of digital skin defects with the ipsilateral forearm venous flap.Methods From August 2015 to August 2018,13 patients with palmar skin defects of the hand were treated with emergency first-stage free forearm venous flap transplantation to repair the wounds.The donor site was directly sutured and followed up regularly.Results A total of 12 flaps survived and 1 was necrotic.Among 12 surviving flaps,4 survived smoothly,with appearance and quality similar to those of physiological flaps.A total of 6 cases showed mild to moderate swelling,congestion and blisters.After timely treatment,the flaps survived smoothly,accompanied by pigmentation of different degrees.2 cases had partial necrosis and healed by dressing change.Conclusion The ipsilateral free forearm venous flap can be applied to repair the palmar skin defect of the hand.The flap is easy to cut and has a high survival rate.It can repair the wound surface at one stage,repair the defect of blood vessels and tendons at the same time without damaging the well-known arteries,and has a satisfactory postoperative appearance.