指背血管蒂逆行岛状皮瓣的临床应用

Clinical application of the reversed island flap pedicled with the dorsal digital vascularity

目的 :探讨一种新的方法修复手指部皮肤软组织缺损。方法 :以手指背血管为蒂 ,于近节指背、指蹼及掌背远端区域设计逆行岛状皮瓣转移至手指皮肤软组织缺损处 ,皮瓣及蒂部包涵指背动脉及指背浅静脉 ,皮瓣供区可直接拉拢缝合或皮片移植修复。结果 :1999年 10月～ 2 0 0 2年 8月 ,临床应用 12例 13个皮瓣 ,11个皮瓣完全成活 ,2个皮瓣发生表皮层坏死 ,经换药后自愈。结论 :指背血管蒂逆行岛状皮瓣邻近手指皮肤软组织缺损区 ,血运可靠 ,可以安全。

Objective:To investigate a new method of repairing the skin and soft tissue defects of the finger.Methods:The flap was designed in the area including proximal digital dorsum,digital web and distal metacarpal dorsum,pedicled with dorsal digital vascularity.In operative procedure,dorsal digital artery and superfacial dorsal digital vein were kept in the pedicle and in the flap.The donor site of the flap was sutured directly or covered with split skin graft.Results:From Jan.1999 to Aug.2002,13 flaps were transported to repair the skin defects of the fingers in 12 cases and 11 flaps survived.Only 2 flaps were necrotic in epidermal layer and cured by changing the dressing.Conclusions:The reversed island flap pedicled with the dorsal digital vascularity adjacent to the skin defects of the fingers has stable blood supply and can be used to repair skin defects of the fingers with the advantages of safety and easy reach.