指背逆行岛状皮瓣修复指端缺损时蒂部不同处理方法比较

目的分析比较几种不同的蒂部处理方法在指背逆行岛状皮瓣修复指端缺损时的临床疗效。方法2005年5月-2011年5月，对36例36指指端缺损患者采用指背逆行岛状皮瓣修复，于手指近节中、远段及近节指间关节背侧设计皮瓣，皮瓣边缘不超过手指侧中线，蒂部采用四种不同的处理方法。结果36例皮瓣全部成活。但不同的蒂部处理方法术后对皮瓣血运的影响不尽相同。结论皮瓣远端血管蒂部附加一条形皮肤较其他蒂部处理方法疗效更确切，不仅解决了转位后蒂部过紧的问题，还可以早期闭合蒂部创面，减少了感染机会，有效地降低了术后并发症的发生。

To contrast different treating approach of the pedicle in the repair of finger tip defects with the reverse dorsal digital island fascial flap

Objective To summarize and contrast clinical effect of the reverse dorsal digital island fascial flap with different treating approach to the flap pedicle. Methods From May 2005 to May 2011, 36 finger tip defects in 36 cases were repaired with this method, the flap was designed on the proximal phalanx at the middle and distal segments and the dorsum of the proximal interphalangeal joint. The lateral margins of the flap did not cross the midlateral line, and there are four different treating approach to the flap pedicle. Results All flaps survived completely, but different handling with the pedicle could bring different influence to the circulartory of the flap. Conclusion The flap pedicle with a strip skin not only can solve the problem of the tense of the flap pedicle but reduce the chance of infection, and effectively cut down the incidence rate of the complication.