拇指桡侧指动脉逆行岛状皮瓣修复拇指软组织缺损

Repair of thumb soft tissue defect with a retrograde island flap of the radial digital artery

目的探讨拇指桡侧指动脉逆行岛状皮瓣修复拇指软组织缺损的临床疗效。方法2018年12月-2021年12月,对收治的9例拇指外伤致软组织缺损,术前采用超声多普勒血流探测仪确定拇指桡侧指动脉走行并标记,根据拇指软组织缺损创面特点,个体化设计拇指桡侧指动脉逆行岛状皮瓣修复拇指软组织缺损创面,观察受区创面皮瓣颜色、温度、两点辨别浅感觉、VAS满意度等监测指标。结果术后随访(6.7±1.2)个月,9例拇指桡侧指动脉逆行岛状皮瓣均成活。创面愈合良好,温度、两点辨别浅感觉、VAS满意度在术后1周、2周、3个月、6个月、12个月进行对比,P<0.05差异有统计学意义。皮瓣色泽良好、质地柔软、弹性良好,拇指指间关节屈伸功能恢复正常。结论拇指桡侧指动脉逆行岛状皮瓣修复拇指软组织缺损操作简单、损伤较小、皮瓣耐磨性能好,可有效修复拇指软组织缺损,临床疗效显著。

Objective To investigate the clinical effect of repairing soft tissue defects of the thumb using a retrograde island flap of the radial digital artery.Methods A retrospective study was performed among nine patients,thumb soft tissue defects caused by trauma from December 2018 to December 2021.A preoperative ultrasonic Doppler blood flow detector was used to mark and determine the shape of the radial digital artery of the thumb.According to the characteristics of soft tissue defects of the thumb,the retrograde island flap of the radial digital artery of the thumb was designed individually to repair soft tissue defects of the thumb.The color,temperature,superficial sensation of two-point discrimination,and visual analog scale(VAS)satisfaction of the retrograde island flap were observed.Results The postoperative follow-up was(6.7±1.2)months.Nine patients with soft tssue defect repair using a retrograde island flap of the radial digital artery survived,and the wound healed well.There were statistically significant differences in temperature,superficial sensation of two-point discrimination,and VAS satisfaction at 1 week,2 weeks,3 months,6 months,and 12 months after operation(P<0.05).The flap had good color,soft texture,and elasticity.The flexion and extension functions of the thumb's interphalangeal joint returned to normal.Conclusion The retrograde island flap of the radial digital artery can repair soft tissue defects of the thumb with a simple operation,less damage,and good wear resistance.It can effectively repair soft tissue defects in the thumb.