胫前动脉化静脉皮瓣修复(足母)趾背侧软组织缺损

目的 探讨应用躅趾背侧软组织缺损的临床效果. 方法 对中(足母)趾背侧软组织缺损的患者12例,采用同侧小腿中远端胫前动脉化静脉皮瓣移植修复,缺损面积为3.0 cm×5.0 cm～4.0 cm×7.0 cm. 结果 12例皮瓣全部成活,术后随访4～12个月,皮瓣外形满意,质地柔软,弹性正常,无色素沉着.修复的(足母)趾功能良好. 结论 小腿中远端胫前动脉化静脉皮瓣移植修复(足母)趾背侧软组织缺损,手术损伤小,供区隐蔽,临床效果良好.     

(足母)趾腓侧游离皮瓣修复指腹缺损

目的 探讨应用(足母)趾腓侧游离皮瓣修复指腹缺损的治疗效果.方法 应用吻合血管的(足母)趾腓侧游离皮瓣用于修复指腹缺损28例,皮瓣切取面积最小1.5 cm×2.O cm;最大2.0 cm×5.0 cm.结果 术后移植皮瓣成活27例,1例坏死.结论 (足母)趾腓侧游离皮瓣是修复指腹缺损较为理想的皮瓣之一.     

深静脉回流型(足母)趾趾腹皮瓣的临床应用

目的 报道应用深静脉回流型(足母)趾趾腹皮瓣修复指腹缺损的临床效果.方法 利用深静脉(腓侧趾底动脉伴行静脉)-交通支-跖背浅静脉的回流途径.切取带有(足母)趾腓侧趾底动脉及伴行静脉的(足母)趾趾腹皮瓣修复指腹缺损5例.皮瓣面积3.0 cm×1.5 cm～5.0 cm×3.0cm.结果 术后随访3～12个月,皮瓣全部成活,修复指腹饱满,有罗纹,出汗,两点分辨觉6～7 mm,外观理想.供区植皮全部成活,行走正常.结论 深静脉回流型(足母)趾趾腹皮瓣手术可作为浅静脉条件不佳时的另一种手术方案,疗效满意.     

应用游离(足母)趾腓侧皮瓣修复拇指指腹缺损

目的 报道应用趾腓侧皮瓣移植修复拇指指腹缺损的临床效果.方法 根据拇指指腹缺损的形状、面积大小设计以跖背动、静脉为蒂的趾腓侧皮瓣游离移植修复创面,临床应用27例. 结果 术后皮瓣均成活.其中获得4个月～2年随访24例,失访3例.根据中华医学会手外科学会手功能评定标准,结果 属优21例、良3例.皮瓣两点辨别觉4～10 mm,修复手指外形较好,供区对行走无影响,步态正常. 结论 趾腓侧皮瓣是修复拇指指腹缺损的较好方法.     

应用改良(足母)趾腓侧皮瓣游离修复拇指指腹缺损12例

目的 报道应用改良(足母)趾腓侧皮瓣游离修复拇指指腹缺损的临床疗效.方法 在常规(足母)趾腓侧皮瓣设计方法的基础上,将皮瓣腓侧缘及近端分别向背侧及趾蹼侧旋转,避开口径细小又紧贴于皮下的腓侧浅静脉,直接游离跖背浅静脉以备吻合:皮瓣的动脉和神经游离仍以常规方式进行处理,临床应用12例.结果 术后12例皮瓣全部成活,经4～15个月随访,均获得满意疗效,供区均一期愈合,供足行走步态正常,拇指指腹饱满有螺纹,皮瓣颜色、弹性、质地良好.结论 应用改良(足母)趾腓侧皮瓣可降低手术难度,供、受区均一期愈合,无破溃发生.修复拇指指腹外形近似,是修复拇指指腹缺损的理想方法.     

(足母)趾与第二足趾并趾修复(足母)甲瓣切取后的创面

目的探索(足母)甲瓣切取后供区遗留创面更好的处理方法.方法采用(足母)趾及第二足趾并趾修复(足母)趾跖侧创面,解决(足母)甲瓣切取后经久不愈或经常发生溃破的创面.结果临床处理(足母)甲瓣切取后创面58例,创面均期愈合,且耐磨,不妨碍行走.结论该术式为(足母)甲瓣切取后遗留创面处理的较佳方法.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

目的 探讨采用各级政(足母)趾胫侧趾底动脉逆行岛状皮瓣修复(足母)趾远端软组织缺损的临床效果.方法 2003至2008年,根据(足母)趾远端软组织缺损的情况,对18例患者采用(足母)趾胫侧趾底动脉逆行岛状皮瓣修复.通过随访观察(足母)趾外形、功能恢复情况,了解临床疗效,总结优缺点.结果 术后随访6～12个月,18例皮瓣全部成活,修复后(足母)趾远端外观尚好,趾端无明显触痛,功能恢复满意.结论 躅趾胫侧趾底动脉逆行岛状皮瓣血管走行相对较为恒定,皮瓣供、受区距离较近,转移方便,手术操作容易,是修复(足母)趾远端软组织缺损的较好方法.     

(足母)趾软组织缺损的显微外科治疗

目的 探讨应用显微外科技术修复(足母)趾软组织缺损的临床效果.方法 采用多种皮瓣进行修复13例,其中足内侧隐神经营养血管蒂皮瓣8例、足背内侧皮神经营养血管蒂皮瓣2例和跗外侧岛状皮瓣3例,均为逆行转移修复.结果 13例中除1例远端浅表坏死外,其余皮瓣全部成活.术后随访6～18个月,平均12个月,成活皮瓣的色泽弹性良好,外形不臃肿,所有病例均恢复了保护性感觉,供区植皮全部成活,无明显疼痛.结论 对于(足母)趾软组织缺损,采用足部皮神经营养血管蒂外科皮瓣进行修复可获得良好的临床效果.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾胫侧趾底动脉逆行岛状皮瓣的临床应用

Objective To study the therapeutic effect of reverse island flap based on tibial plantar digital artery for soft tissue defect at the distal end of first toe. Methods 18 cases with soft tissue defect at the distal end of first toe were treted with reverse island flap based on tibia] plantar digital artery. Results The patients were followed up for 6 ～ 12 months(mean 9.5 months). All the flaps survived completely with good functional and cosmetic results. Conclusions The reversed island flap based on tibia] plantar digital artery has a reliable blood supply and is adjacent to the recipient area. It is practical and suitable for soft tissue defect at the distal end of first toe.     

(足母)趾背U形皮瓣在第二趾带足背皮瓣移植供区修复中的应用

目的 探讨应用(足母)趾背U形皮瓣在第二趾带足背皮瓣移植供区修复中的临床疗效. 方法 2003年3月至2010年2月应用(足母)趾背U形皮瓣联合全厚皮片植皮修复足第二趾带足背皮瓣移植再造拇、手指后的供区26例.U形皮瓣切取面积3.0 cm×2.0 cm～ 4.5 cm × 3.0 cm. 结果 26例皮瓣、足背植皮全部一期存活,随访6个月～2年,皮瓣质地优良,重建趾蹼外观满意,足趾伸、屈活动不受限,行走无障碍. 结论 应用(足母)趾背U形皮瓣来修复足第2趾带足背皮瓣移植后供区临床效果满意,可以最大程度减少供区并发症的发生.     

(足母)趾系列皮瓣

1980年，Morrison等首先为1例拇指皮肤套状撕脱伤者，选用[足母]趾甲皮瓣移植施行拇指再造获得成功，为拇指皮肤套状撕脱伤的治疗开拓了新的方法。我们在临床应用[足母]趾甲皮瓣施行拇指再造与修复中获得较大的启发，根据[足母]趾的应用解剖，拓宽了对[足母]趾甲皮瓣的认识，从而开发出[足母]趾系列皮瓣。皮瓣切取范围：第一跖骨远1／3以远除保留[足母]趾胫侧舌状瓣外[足母]趾任何部位的组织。皮瓣切取后不仅保留原[足母]趾外形，长度与功能，为手指部分皮肤及复合组织等缺损的修复与重建，取得了满意的专科修复效果。