第一跖背筋膜皮瓣逆行转移修复第二足趾胫侧皮瓣供区

Reverse transfer of the first metatarsal dorsal fascia flap in the repair of donor site of the second toe tibial flap

目的探讨第一跖背筋膜皮瓣修复第二足趾胫侧皮瓣供区创面的临床效果。方法自2018年1月至2019年7月,苏州大学附属瑞华医院手外科对10例采用游离第二足趾胫侧皮瓣修复手指创面的患者,应用第一跖背筋膜皮瓣修复第二足趾供区创面,切取皮瓣大小2.5 cm×2.0 cm~4.5 cm×3.0 cm,供区直接缝合。结果本组10例患者皮瓣全部成活,其中2例第一跖背筋膜皮瓣术后皮缘出现瘀斑,经间断拆线后瘀斑逐渐消失,术区伤口均一期愈合。随访3~18个月,平均5个月,外观较满意,第一跖背筋膜皮瓣感觉恢复至S2~S3,足部供区仅遗留线状瘢痕。结论采用第一跖背筋膜皮瓣修复第二足趾胫侧皮瓣供区创面,可避免传统方法修复术后出现各种并发症,是一种较理想的修复第二足趾胫侧皮瓣供区创面的新方法。

Objective To explore the clinical efficacy of the first metatarsal dorsal fascia flap in the repair of donor site wounds of the second toe tibial flap.Methods From January 2018 to July 2019,the finger wounds in 10 patients were repaired by free second toe tibial flap,and the donor wounds in the second toe were repaired by the first metatarsal dorsal fascia flap.The area of flap was from 2.5 cm×2.0 cm to 4.5 cm×3.0 cm.The donor site was directly sutured.Results All flaps in 10 patients survived.In 2 patients,ecchymosis appeared in the skin margin of the first metatarsal dorsal fascia flap after operation and disappeared after intermittent thread removal.All wounds were healed in one stage.The follow-up period was from 3 to 18 months,with an average of 5 months.The appearance of the first metatarsal dorsal fascia flap was satisfactory.The sensation recovered to S2 to S3.Only linear scar left in the donor site of foot.Conclusion The application of the first metatarsal dorsal fascia flap in the repair of donor site wounds of the second toe tibial flap could avoid various postoperative complications of traditional methods.This is an ideal method to repair donor site wounds of the second toe tibial flap.