第二掌背动脉岛状皮瓣的临床应用

目的：通过解剖学研究，设计第２掌背动脉岛状皮瓣，临床修复手部皮肤缺损，获得成功。方法：对５０只经动脉灌注红色乳胶的成人手标本，在放大镜下观察第２掌背动脉及伴行静脉的起端，皮支、终末支的走行；测量血管各部位的直径。结果：第２掌背动脉终末支分布于第２指蹼、示中指近节皮肤；皮支和其它掌背、掌指动脉间有丰富的吻合支。临床应用８例，顺行皮瓣７例，逆行１例。修复手背、拇指皮肤缺损，皮瓣全部成活。结论：临床应用第２掌背动脉为蒂的岛状皮瓣时，可设计成顺行或逆行皮瓣，均能成活。

The clinical application of second dorsal metacarpal artery island flap

The second dorsal metacarpal artery island flap was designed on the basis of anatomic study and applied in the repair of skin defect in the hand. 50 adult hands were perfused with emulsion through arteries. The beginnings of the second dorsal metacarpal arteries and their accompanying veins, the cutaneous branches were observed under magnification. The diameters of the vessels were measured. The ending branches of the second dorsal metacarpal arteries were distributed in the second web-space, proximal parts of the index and middle fingers. Many anastomotic branches were found between the cutaneous branches and metacarpophalangeal arteries or other dorsal metacarpal arteries. This flap was applied in 8 patients, with 7 anterograde flaps and 1 retograde flap. All the flaps succeeded. So both anterograde and retrograde island flap can be designed with second dorsal metacarpal artery pedicle.