吻合邻指指背皮瓣静脉治疗断指再植术后静脉危象的处理

目的介绍用吻合邻指指背皮瓣静脉治疗断指再植术后出现静脉危象的方法。方法对8例再植指术后3～48h出现静脉危象经保守治疗无效者，取邻指背侧带蒂皮瓣转位至再植指指背区，切除再植指指背栓塞静脉段及炎性水肿皮缘后，将皮瓣静脉与指背静脉吻合。术后4周断蒂。结果8例再植指全部存活。术后随访3～12个月，按中华医学会手外科学会上肢部分功能评定试用标准评定，优良率为87．5％。供指无明显功能障碍。结论利用邻指带蒂背侧皮瓣移位可修复再植指的静脉回流，又可用健康皮肤覆盖创面，手术简便，效果好，实用性强。

Anastomosing dorsal vein of cross-finger flap to relief venous crisis after digit replantation

Objective To introduce a procedure of anastomosing dorsal vein of cross-finger flap to relief venous crisis after digit replantation. Methods 8 replanted fingers with venous crisis 3-48 hours after the operation that couldn't be corrected by conservative treatment were salvaged by the following procedure.The dorsal cross-finger flap was transferred to the replanted finger at the dorsal part. The thrombus venous segment and the part of skin with inflammation were excised. The veins of the flap were anastomosed with that of the injured finger. The pedicle was divided after 4 weeks. Results Complete relief of venous crisis occurred in 8 cases. The follow-up period ranged from 3 to 10 months. According to the upper limb partial function evaluation standard issued by Hand Surgery Society of Chinese Medical Association, the excellent and good rate was 87.5%. The donor finger had no finger dysfunction. Conclusion The transfer of cross-finger dorsal flap can reflow the vein of the replanted finger and cover the wound with healthy skin. The procedure is simple, efficient and practical.