桡动脉腕横纹穿支皮瓣游离移植修复手指皮肤软组织缺损

Repair of finger soft tissue defects with free transplantation of radial artery wrist transverse perforator flap

目的探讨应用游离桡动脉腕横纹穿支皮瓣移植修复手指皮肤软组织缺损的临床疗效。方法2018年9月-2019年12月采用游离桡动脉腕横纹穿支皮瓣修复手部软组织缺损12例。皮肤缺损面积:1.6 cm×2.0 cm~2.5 cm×3.5 cm,皮瓣切取面积:2.0 cm×2.0 cm~2.5 cm×4.0 cm。术后定期门诊随访,观察皮瓣成活情况并指导功能训练,评价临床效果。结果术后12例游离皮瓣全部成活,其中1例出现血运瘀滞,皮瓣张力高,有水疱形成,经换药、松解、拆除部分缝线后好转。随访6~12个月,平均9个月,皮瓣血运好,患指外形佳,屈伸功能好,腕部瘢痕轻,无不适感,两点辨别觉6~9 mm。结论应用游离桡动脉腕横纹穿支皮瓣移植修复手指皮肤软组织缺损,术后外形、功能恢复好,临床疗效满意。

Objective To investigate the clinical efficacy of free transplantation of radial artery wrist transverse perforator flap on repair of finger skin defects.Methods From Sep 2018 to Dec 2019,12 patients with finger skin defects were treated.All the wounds were combined with bone and tendon exposure.The area of skin defects ranged from 1.6 cm×2.0 cm to 2.5 cm×3.5 cm.The flap areas ranged from 2.0 cm×2.0 cm to 3.0 cm×3.5 cm.Regular outpatient follow-up after surgery had been made to observe flap survival and guide function exercise,and evaluate clinical efficacy.Results All 12 free flaps survived,with blood stasis in one case,the flap had high tension,blister formation,after wound dressing,released part of the suture to turn well.Follow-up time lasted for 6-12 months,with an average of 9 months.The flap was revascularized with good patient finger profile,had good flexion extension function,mild wrist scar and no discomfort,two point discrimination was 6 to 9 mm.According to the Upper Extremity Functional Evaluation Tentative Criteria set up by Hand Surgery Branch of Chinese Medical Association,8 fingers were excellent,3 fingers were good,and 1finger was fair.Conclusion The application of free transplantation of radial artery wrist transverse perforator flap for repair of finger skin defects,has good postoperative profile and functional recovery,has good clinical efficacy.