前臂掌侧游离动脉化静脉皮瓣不同改良方式修复指端缺损的临床应用

Different reconstruction methods of free arterialized vein flap in forearm for repairing phalanx defect

目的探讨动脉化静脉皮瓣不同改良方式修复手指指端软组织缺损的手术方法。方法2009年10月-2019年10月,对56例指端软组织缺损患者在双干静脉之间切开脂肪层至真皮下血管网,将双干之间交通支断口结扎;根据皮瓣大小,对动脉化静脉属支进行选择性结扎,控制皮瓣供血入量使之供血均匀。结果本组术后56例中30例皮瓣红润,17例出现少量散在水疱,9例3~7 d出现瘀血肿胀,经对症处理后56例皮瓣全部成活,优良率达89.3%(50例)。结论经过不同改良的动脉化静脉皮瓣修复手指末节软组织缺损外观满意,有一定的临床意义。

Objective To explore the methods of repairing soft tissue defect of the distal segment of fingers with different reconstruction methods of arterialized venous flap.Methods From October 2009 to October 2019,"furrow"was made between the two trunk veins in 56 cases with fingertip defect,the fat layer was cut into the subdermal vascular network,and the junction between the two trunk veins was ligated.According to the size of the flap,selective ligation of the arterial branches was carried out to control the blood supply of the flap,to make the blood supply uniform.Results There were 56 patients in this group,and 30 patients were ruddy after surgery.There were 17 cases of scattered blister,9 cases of swelling 3~7 days after operation.All the 56 flaps survived,and the good rate was 89.2%(50 cases).Conclusion The arterialized venous flap with different modifications has satisfactory appearance for repairing the soft tissue defect of the distal segment of fingers,and has certain clinical significance.