指动脉背侧支逆行筋膜蒂岛状皮瓣修复手指皮肤缺损

目的介绍一种修复手指皮肤缺损的指动脉背侧支逆行筋膜蒂岛状皮瓣的临床应用。方法2001年9月～2002年12月以近节或中节指固有动脉背侧支为蒂,切取掌骨头背侧或近节手指背侧皮瓣,逆行修复近节指间关节或以远的皮肤缺损35例42指,同时对伴有骨、关节、肌腱等损伤者进行修复。皮瓣切取范围1.0cm×2.5cm～1.5cm×3.5cm。结果术后35例42指获3个月～1年随访,皮瓣全部成活;两点辨别觉6～10mm,指外形及功能佳。结论此皮瓣具有手术操作简便、不损伤指固有动脉及神经,血管蒂长、旋转弧大和成功率高等优点,是修复手指皮肤缺损较理想的方法。

REPAIR OF DEFECT ON FINGER SKIN WITH REVERSE FASCIAL PEDICLE ISLAND FLAP OF DORSAL BRANCHE OF DIGITAL ARTERY

OBJECTIVE: To introduce the surgical procedure and indication of the reverse fascial pedicle island flap of the digital artery dorsal branches in repairing finger skin defect. METHODS: By use of the dorsal branches of the digital artery as the pedicel, the reverse island flap was designed. The skin defects of the proximal interphalangeal joint and beyond in 35 cases (42 fingers) were repaired and the joint or extensor tendon was reconstructed simultaneously. Donor site was primarily closed or a skin graft was used. The flap size ranged from 1.0 cm x 2.5 cm to 1.5 cm x 3.5 cm. RESULTS: Thirty-five patients were followed up 3 months to 1 year, all the flaps survived. The two-point discrimination was between 6 mm and 10 mm. The function of interphalangeal joint was satisfactory. CONCLUSION: These flaps have the advantages of an extended skin paddle and a versatile pivot point on the phalanx, and they allow coverage of wide and distal defects.