手部皮神经营养血管逆向岛状皮瓣修复手指软组织缺损

目的:报道应用手部皮神经营养血管皮瓣修复手指软组织缺损的方法和疗效。方法:应用手部掌背皮神经(桡神经浅支及尺神经手背支)营养血管皮瓣修复手指软组织缺损17例(19指)。男14例,女3例。年龄31~68岁。皮瓣大小为2.0cm×1.5cm~8.0cm×3.0cm。皮瓣供区植皮。结果:临床应用皮神经营养血管皮瓣17例全部成活。术后随访6~24个月,平均12月。皮瓣外形满意,质地、色泽、弹性好,手指功能良好。结论:桡神经浅支及尺神经手背支营养血管皮瓣不损伤主要血管、神经,操作简单,是修复手指软组织缺损的理想皮瓣之一。

Repair of Soft Tissue Defects of the Fingers with Dorsal Reverse Island Neuroucutaneous Flaps from the Hand

Objective:To explore the treatment outcome of using dorsal reverse island neurocutaneous flaps from dorsum of the hand for repair of finger soft tissue defects. Methods:Seventeen cases(nineteen fingers) reverse island flaps pedicled on the nutritinal vessels of dorsal metacarpal cutaneous nerve(superficial branch of radial nerve or dorsal branch of ulnar nerve) were used to repair skin defects of the fingers. Of these, 3 were females and 14 were males, with an age range from 31 to 68 years. The size of the flap ranged from2.0cm×1.5cm to 8.0cm×3.0cm. The donor sites of the medial dorsal reverse is long neurocutaneous flaps were resurfaced with skin grafts. Results:Seventeen cases(nineteen fingers) reverse island flaps pedicled on the nutritinal vessels of dorsal metacarpal cutaneous nerve survived uneventfully. Postoperative follow up period ranged from 6 to 24 months, with an average of 12 months. The appearance, texture, color and elasticity of the flaps were good. Recovery of the hand function was good. Conclusion:Superficial branch of radial nerve or dorsal branch of ulnar nerve dorsal reverse island neurocutaneous flap does not sacrifice major vessels and nerves. The operation is simple. It is an ideal method for repairing soft tissue defects of the finger.