尺动脉近端穿支皮瓣修复指掌侧面皮肤软组织缺损

Proximal Ulnar Artery Perforator Flap Repairing Skin and Soft Tissue Defect on the Volar Suface of Digits

目的探讨尺动脉近端穿支皮瓣修复指掌侧面皮肤软组织缺损的临床疗效。方法回顾性分析2019年4月至2021年2月我院收治的11例指掌侧面皮肤软组织缺损病人的临床资料,其中男7例,女4例,年龄为20~52岁,平均31.2岁,均采用尺动脉近端穿支皮瓣修复指掌侧面皮肤软组织缺损。皮肤软组织缺损面积为2.4 cm×1.8 cm~5.8 cm×2.5 cm,平均4.2 cm×2.2 cm。皮瓣切取面积为2.9 cm×2.3 cm~6.3 cm×3.0 cm,平均4.7 cm×2.7 cm。参照美国手外科协会总主动活动度(total action movement,TAM)系统评定手指功能。结果11例皮瓣均成活,外形满意,伤口均一期愈合。全部病例获得随访,随访时间为6~22个月,平均8.4个月。皮瓣肤色红润,质地良好,厚薄适中,指掌侧面外形佳,弧度可,两点辨别觉为3.3~5.2 mm,平均4.0 mm。供区仅留有线形疤痕,无明显障碍。按TAM系统评定手指功能:优9例,良2例,优良率为100%。结论尺动脉近端穿支皮瓣能有效修复指掌侧面皮肤软组织缺损,是一种行之有效的方法。

Objective To explore the clinical effect of the proximal ulnar artery perforator flap repairing skin and soft tissue defect on the volar suface of digits.Methods The clinical data of 11 patients with skin and soft tissue defect on the volar suface of digits undergoing the proximal ulnar artery perforator flap repair in our hospital from April 2019 to February 2021 were analyzed retrospectively analyzed,including 7males and 4 females,with age of 20-52 years old(mean age 31.2 years old).The proximal ulnar artery perforator flap was used to repair the skin and soft tissue defect on the volar suface of digits.The defect area of the skin and soft tissue defect was from 2.4 cm×1.8 cm to 5.8 cm×2.5 cm,and the mean area of all wounds was 4.2 cm×2.2 cm.Sizes of the flaps ranged from 2.9 cm×2.3 cm to 6.3 cm×3.0 cm,with a mean of 4.7 cm×2.7 cm.Finger function was evaluated according to the total active range of motion(TAM)system of the American Association of Hand Surgeons.Results All flaps survived and the outline was good.The wound healed by first intention in11 cases.All patients were followed up for 6 to 22 months,average 8.4 months.The flaps had good consistency and color,contour of the dorsum of hand was satisfactory,two-point discrimination was 3.3 to 5.2 mm,with a mean of 4.0 mm.The donor site has little effect on appearance and no abnormal function.According to the TAM system of the American Association of Hand Surgery,the finger function was excellent in 9 cases and good in 2cases.The excellent and good rate was 100%.Conclusion The proximal ulnar artery perforator flap was not only simple and convenient but also effective and feasible to repair skin and soft tissue defect on the volar suface of digits.