指动脉关节穿支血管链皮瓣修复手指皮肤软组织缺损

Repair of finger skin and soft tissue defects with finger artery joint perforator vascular chain flap

目的探讨指动脉关节穿支血管链皮瓣修复手指皮肤软组织缺损的临床疗效。方法2019年7月-2020年10月,采用指动脉关节穿支血管链皮瓣修复手指皮肤软组织缺损26例(32指),其中急诊手术18例,择期手术8例,皮肤软组织缺损面积:0.8 cm×1.2 cm~2.0 cm×2.8 cm,皮瓣面积:1.0 cm×1.5 cm~2.5 cm×2.8 cm。结果32指皮瓣全部成活,其中4指皮瓣出现张力性水疱,给予穿刺抽液及拆除蒂部部分缝线后,皮瓣顺利成活,并均得到有效随访6~12个月。患指皮瓣外形、伸屈功能满意,能胜任伤前日常生活与工作需要。3例患者感觉恢复较差,两点辨别觉8~10 mm。手功能评定采用手指关节总活动度(TAM)法,优18例,良6例,可2例。结论指动脉关节穿支血管链皮瓣修复手指皮肤软组织缺损,具有手术操作简单、血运可靠、皮瓣成活率高、外形恢复好等优点,可以较早地恢复日常生活与工作,是修复手指皮肤软组织缺损的理想皮瓣。

Objective To observe the clinical effect of finger artery joint perforator vascular chain flap in repairing finger skin and soft tissue defects.Methods From July 2019 to December 2020,26 cases(32 fingers)were treated in our department.The skin and soft tissue defects of fingers were repaired by finger artery joint perforator vascular chain flap.Among them,18 cases were emergency operation,and 8 cases were selective operation.The area of skin and soft tissue defects was about 0.8 cm×1.2 cm~2.0 cm×2.8 cm,and the area of flap was about 1.0 cm×1.5 cm~2.5 cm×2.8 cm.Results All 32 flaps survived.Tension blisters appeared in 4 flaps,and survived successfully after puncture and removal of partial sutures.All flaps were followed up for 6 to 12 months.Patients can resume normal work and life.The sensory recovery of 3 patients was poor,and the two-point discrimination was 8-10 mm.According to the Total Range of Motion(TAM)method,18 cases were excellent,6 cases were good and 2 cases were fair.Conclusion The finger artery joint perforator vascular chain flap has the advantages of simple operation,reliable blood supply,high survival rate of flap,good appearance recovery,early recovery of normal work and life.It is an ideal flap for repairing finger skin and soft tissue defects.