游离桡动脉联体穿支皮瓣修复手指较大皮肤软组织缺损

目的探讨游离桡动脉联体穿支皮瓣修复手指较大皮肤软组织缺损的方法及临床疗效。方法2015年6月-2019年8月,采用桡动脉联体穿支皮瓣修复手指较大皮肤软组织缺损11例,皮瓣切取范围为2.5 cm×5.5 cm^3.0 cm×7.5 cm。供区直接拉拢缝合。术后随访3~26个月,观察皮瓣的质地、外观、感觉及手指功能情况。结果11例皮瓣全部顺利成活,伤口均Ⅰ期愈合。术后9例获得随访,随访时间3~26个月,平均18个月。皮瓣质地好,未见明显臃肿,皮色与受区相近,两点辨别觉8~12 mm,平均10 mm。供区只留线性瘢痕。结论采用桡动脉联体穿支皮瓣修复手指较大皮肤软组织缺损,增加了皮瓣的切取范围,不损伤主干血管,切取简便,成活率高,色泽和质地与受区相近,手指功能良好,供区可直接缝合,是修复手指较大皮肤缺损的一种理想方法。

Repair of large finger skin defect with free radial artery conjoined perforator flap

Objective To explore the method and clinical effect of free radial artery combined perforator flap on repairing large finger skin defects.Methods From June 2015 to August 2019,11 cases of large skin defects were repaired with radial artery perforator flap.The range of skin flap incision was from 2.5 cm×5.5 cm to 3.0 cm×7.5 cm.The donor site was sutured directly.The patients were followed up for 3 to 26 months to observe the texture,appearance,sensation and finger function of the flap.Results All 11 cases of skin flaps survived successfully after operation,and the wounds healed by first intention.Nine patients were followed up for 3 months to 26 months,with an average of 18 months.The flaps were of good texture and no obvious edema.The skin color was similar to that of the recipient site.The two-point discrimination was 8 to 12 mm,with an average of 10 mm.Only linear scar was left in donor site.Conclusion The radial artery combined perforator flap is an ideal method for repairing large skin defects of fingers,which has the advantages of increasing the range of skin flaps without damaging the main blood vessels,simple cutting,high survival rate,similar color and texture to the recipient site,good finger function,direct suture of the donor site.