微型皮瓣修复复杂性手指皮肤软组织缺损

目的探讨微型皮瓣修复复杂性手外伤手指皮肤软组织缺损的方式和临床效果。方法采用多种吻合血管及带蒂微型皮瓣(游离尺动脉腕上皮支皮瓣、前臂静脉皮瓣、掌背动脉岛状皮瓣、拇指背侧皮神经伴行血管皮瓣、指动脉岛状皮瓣、踇趾系列皮瓣)修复343例复杂性手外伤手指皮肤软组织缺损。皮瓣面积1.0cm×1.5cm～2.5cm×6.0cm,手术方法为游离移植或带蒂转移。结果343例完全成活,皮瓣质地、外观、功能、感觉恢复良好。结论微型皮瓣修复复杂性手外伤手指皮肤缺损具有创伤小、利于指体功能及外形恢复等优点,具有临床应用价值。

Repair of finger skin defect after complicated hand trauma by using miniflaps

Objective To probe into the methods and evaluate clinical effect in the treatment of fonger skin defect after complicated hand trauma by using all kinds of miniflaps.Method The 343 cases of finger skin defect after complicated hand trauma were repaired by using several free flaps or pedicled flaps(freed supracarpal cutaneous branch flaps of ulnar artery,vein flaps of forearm,dorsal metacarpal artery flaps,dorsal thumb neurocutaneous vasotrophic island flaps,finger artery island flaps and series flaps derived from hallux).The area of the flap was 1.0cm×1.5cm-2.5cm×6.0cm.All the flaps were free flaps or pedicled flaps.Result All the flaps were survived in the 343 cases after operation and the texture,shape,function and the sensory recovery was good.Conclusion Repair of finger skin defect after complicated hand trauma by using one or several kinds of miniflaps has the advantage such as less injuries and promoting the recovery of the hand function and shape.