同指背侧皮神经营养血管皮瓣修复指端缺损

目的 总结同指背侧皮神经营养血管皮瓣逆行转移修复指端软组织缺损的临床效果.方法 于伤指近节背桡侧或背尺侧(拇指为第一掌骨背桡侧或背尺侧)设计皮瓣,深筋膜下锐性分离,逆行转移修复指端缺损.如修复指腹,将皮瓣携带的皮神经与伤指指固有神经相缝合,重建感觉功能.结果 临床应用31例39指,1例皮瓣远端1/3部分出现坏死,换药后愈合;4例出现张力性水泡,表皮脱落后皮瓣存活;其余皮瓣均全部存活.结论 该类皮瓣切取简单,外观好,对供区损伤小,转移随意性强,并可重建皮瓣感觉功能,是修复指端软组织缺损较为理想的方法.

Fingertip reconstruction by dorsal neurocutaneous flap from the same finger

Objective To summarize the clinical outcomes of retrograde transfer of the dorsal neurocutaneous flap from the same finger for coverage of fingertip defects. Methods Skin flap was designed on the radial-dorsal or ulnar-dorsal side of the proximal phalanx of the fingers or of the metacarpal level of the thumb.Dissection was carried out undcr the deep fascia.The flap was then brought to the fingertip retrogradely to repair the skin defect.When the defect was at the finger pulp,the cutaneous nerve of the skin flap was coapted with the proper digital nerve of the recipient finger to restore sensation. Results A total of 39 fingers in 31 patients were treated with this flap.Distal one-third flap necrosis occurred in one case.After debridement the wound healed by dressing change.Four of the cases had tensional blister.The flaps survived after the epidermis peeled off.The skin flaps of the rest cases had 100%survival and wound healing was uneventful. Conclusion Such flap is easy to harvest,has a big ale of transfer and good appearance,causes minor morbidity to the donor site and Can he used to restore sensation.It is an ideal procedure for repmr of soft tissue defect of the fingertip.