带足背皮神经的第1跖背动脉皮瓣修复食指皮肤缺损

目的：探讨带足背内侧皮神经的第1跖背动脉皮瓣修复食指皮肤缺损的临床应用及疗效。方法2002年3月-2012年5月，采用第1跖背动脉皮瓣游离移植修复食指皮肤缺损25例。结果25例获随访6～48个月，平均24个月。术后22例伤口一期愈合，皮瓣及植皮完全成活，食指屈伸功能正常，完全恢复正常生活及工作；2例皮瓣基本成活，远端部分坏死，足背供区植皮部分坏死，经清创换药后二期愈合，食指屈伸功能轻度受限，较好地恢复生活及工作；1例皮瓣完全坏死，改为同侧带蒂腹股沟皮瓣修复后治愈，足背供区植皮成活，食指屈伸功能明显受限。结论第1跖背动脉皮瓣游离移植是修复食指皮肤缺损的理想术式，该皮瓣解剖位置恒定，操作较可靠，成活率较高，外观、功能恢复优良，效果满意。

Repair of skin defect on the point finger utilizing skin flaps with foot medial dorsal cutaneous nerves and the first dorsal metarsal artery

Objective To investigate the efficacy of repairing skin defects on the point finger using skin flaps with foot medial dorsal cutaneous nerves and the first dorsal metarsal artery. Methods 25 patients, aged from 15 years to 63 years, with skin defects on the first finger were included in this study. Results All cases were followed up for 24 months on average （from 6 to 48 months）. Of all the patients, 22 obtained primary wound healing, which means the skin flaps survived successfully and their point fingers had well flexion and extension function. The skin flaps did not survived fully in 2 cases, with necrosis on flap edges. After debridement, the fingers of these two patients survived eventually, although the fingers＆#39;flexion-extension function was not fully recovered. As for the other patient, the skin flap did not survived and another skin flap from inguinal had to be transplanted. The finger had no well function after retransplantation. Conclusion Having a fixed anatomical position and high survival rates, skin flaps with the first dorsal metarsal artery were ideal for the repair of point finger skin defects. The recovery in the appearance and function of the point finger can be easily obtained.