指蹼局部皮瓣在指固有动脉背侧支皮瓣供区修复中的临床疗效

Clinical Effect of Finger Web Local Flap on Donor Area Repair of Dorsal Branch of Proper Digital Artery

目的:探讨应用指蹼局部皮瓣对修复指固有动脉背侧支皮瓣供区的疗效。方法:2014年5月~2017年8月,对35例(35指)指端缺损患者,采用手指近节指固有动脉背侧支皮瓣转移修复。供区采用两种方法修复,观察组以指蹼局部皮瓣修复(20例20指),对照组于同侧前臂近端尺侧取全厚皮片移植修复(15例15指)。术后比较两组患指供受区皮瓣存活情况、外观及质地、皮瓣及手指感觉、手指功能活动、患者主观满意度等指标。结果:术后所有皮瓣完全成活,供区切口一期愈合率93%以上。观察组皮瓣供区外观、质地、感觉优于对照组(P<0.05),患者对外观和感觉满意度评分均高于对照组(均P<0.05)。结论:指蹼局部皮瓣血供可靠,质地良好,供区隐蔽,是修复指固有动脉背侧支皮瓣供区的有效方法。

Objective:To explore the effect of finger web local flap on donor site repair of dorsal branch of proper digital artery.Methods:There were 35 patients(35 fingers)with fingertip defects repaired by dorsal branch of proper digital artery flap from May 2014 to August 2017.The donor site was repaired by two methods.The observation group was repaired with finger web local flap(20 cases with 20 fingers),and the control group was repaired with full thickness skin graft that was taken from the ulnar side of the ipsilateral proximal forearm(15 cases with 15 fingers).The flap survival rate,appearance,texture,sensation,finger movement and subjective satisfaction were analyzed.Results:All flaps survived completely post operatively.The primary healing rate of donor incision was more than 93%.The appearance,texture and sensation of the flap donor site in the observation group were superior to the control group(P<0.05).The patient's satisfaction with appearance and feeling in the observation group were both higher than those of the control group(both P<0.05).Conclusion:The finger web local flap has reliable blood supply,good texture and concealed donor site,which is an effective method to repair donor site of the dorsal branch of the proper digital artery.