改良的尺动脉腕上皮支皮瓣修复手掌软组织缺损

REPAIR OF PALM DEFECTS WITH IMPROVED FLAPS PEDICLED WITH DORSAL CARPAL BRANCH OF ULNAR ARTERY

目的 探讨经改良的尺动脉腕上皮支皮瓣修复手掌软组织缺损的方法。 方法 根据尺动脉腕上皮支及前臂内侧皮神经的走行设计改良皮瓣 ,于腕上皮支起点的近端 1cm处结扎并切断尺动脉 ,形成以尺动脉携腕上皮支和前臂内侧皮神经为蒂的改良皮瓣。 1997年 8月～ 2 0 0 1年 11月 ,用此皮瓣修复手掌软组织缺损 15例 ,其中急诊手术7例 ,择期手术 8例 ,皮瓣范围 7cm× 5 cm～ 12 cm× 8cm。 结果 术后随访 3周～ 6个月 ,15例皮瓣全部成活 ,皮瓣远端无缺血、坏死 ,外观及功能满意。 结论 改良的尺动脉腕上皮支皮瓣的血管蒂长、血供丰富、具有感觉 ,可修复手掌任何部位的缺损 ,且手术操作简便易行。

Objective To discuss the method to repair the defects of palm with the improved flaps pedicled with the dorsal carpal branch of ulnar artery. Methods The improved flaps were designed on the basis of anatomical distribution of the dorsal carpal branch of ulnar artery and the medial antebrechial cutaneous nerve, the ulnar artery was ligated and cut at the beginning of its dorsal carpal branch. The flap pedicled with dorsal carpal branch including the distal ulnar artery was achieved and applied clinically to repair 15 cases of the skin and soft tissue defects of palm from August 1997 to November 2001. The size of flaps ranged from 7 cm ×5 cm to 12 cm ×8 cm. Results All of the cases were followed up 3 weeks to 6 months, and the flaps completely survived. There was no ischemia and necrosis at the distal part of flaps and the appearance and function was satisfactory. Conclusion The improved flap has long vascular pedicle, abundant blood supply and sensitive sensation, so it can be used to repair defect of palm.