手背U-Ⅰ型血管蒂岛状皮瓣的临床应用

Clinical application of U - I shaped vascular pedided island flap in dorsal hand

目的 介绍应用手背U-I型血管蒂岛状皮瓣修复示、中指近侧指间关节以远皮肤软组织缺损的手术方法。方法 以第一掌背动脉为皮瓣血管轴,部分桡动脉、腕背动脉弓及第二掌背动脉为血管蒂,第二掌背动脉远端为旋转点的手背U-I型血管蒂岛状皮瓣转移修复示、中指软组织缺损11例。结果 10例皮瓣全部存活,1例因伤口感染导致皮瓣坏死。结论 该皮瓣血管蒂长,转移范围大,是治疗示、中指近侧指间关节以远掌、背侧软组织缺损的较好方法。

Objective To introduce a procedure of the dorsal hand U - I shaped vascular pedicled flap for repair of soft tissue defects beyond the proximal interphangeal joint of the index and middle finger. Methods The first dorsal metacarpal artery served as the flap vessel axis. The pedicle was part of radial artery, the dorsal carpal arch and the second dorsal metacarpal artery. The flap had a rotation point at the distal part of the second dorsal metacarpal artery. The soft tissue defects beyond the proximal interphalangeal joint of index and middle finger were repaired in 11 cases. Results All 10 cases of flap were survived, except necrosis in 1 case resulted from the wound infection. Conclusion The flap, which has longer vascular pedicle and very wide arc of rotation, is especially useful in repair of soft tissue defect beyond the proximal interphalangeal joint of the index and middle finger.