应用小皮瓣急诊修复拇指软组织缺损

目的 报道拇指软组织缺损的皮瓣修复方法及临床效果。方法 根据拇指软组织缺损的不同情况，采用6种小皮瓣进行修复，包括拇指桡侧指动脉逆行岛状皮瓣、拇指尺背动脉逆行皮瓣、第一掌背动脉逆行皮瓣，示指背侧岛状皮瓣、带神经血管蒂的V-Y推进皮瓣以及拇甲瓣等。临床应用132例，共137个皮瓣。结果 术后有5例皮瓣出现表皮小部分坏死，经换药处理后愈合，其余均成活。随访1～2年，拇指功能、外形满意。结论 对拇指软组织缺损选择恰当的小皮瓣急诊修复，可获得满意的临床效果。

Emergency repair of soft tissue defect at thumb using miniature flaps

Objective To report the treatment outcomes and repair methods for soft tissue defects at thumb using miniature flaps. Methods Six different kinds of surgical flaps were used for the repair on different thumb injuries. They were radial lateral thumb reverse island flap, dorsal ulnar thumb revers flap, first metacarpal dorsal reverse flap, first digital dorsal island flap, neurovessel pedicled V-Y advanced island flap, free nail flap first foot digital, and so on. The emergency repair using miniature flaps were studied on 132 differant cases, all 137 flaps. Results The flaps survived expect 5 flaps had partial epidermis necorsis in the 137 flaps. But the 5 flaps survived too after disinfecting and changing dressing. The appearances and functions of thumbs were satisfactory for the 1 to 2 years post-operation follow-up. Conclusion It will gain better results if choosing appropriate emergency repair methods using miniature flaps on different cases.