带指背静脉、神经的指背筋膜蒂岛状皮瓣修复手指皮肤伴指动脉缺损

目的 探讨同指逆行或邻指顺行带静脉、神经的指背筋膜蒂岛状皮瓣修复伴有指固有动脉、神经缺损的手指掌侧皮肤缺损的方法及疗效.方法 2011年8月-2013年3月对18例伴有指固有动脉、指固有神经缺损的指掌侧皮肤软组织伴指动脉缺损患者,采用同指逆行或邻指顺行带静脉、神经的指背岛状皮瓣转位桥接修复,皮瓣切取面积为1.2 cm×1.5 cm～2.5 cm×3.5 cm,供区创面植皮.结果 术后18例皮瓣及患指均成活.皮瓣供区创面一期愈合.随访6～12个月,皮瓣质地、外观良好.感觉恢复至S3～S4,两点分辨觉4～8 mm.患指运动功能恢复良好.结论 采用带静脉、神经的指背岛状皮瓣桥接修复伴指固有动脉、指固有神经缺损的指掌侧缺损,操作简单、不牺牲主要血管、桥接可靠.供区损伤小,并可重建远端指及皮瓣感觉,是修复指腹软组织缺损、血运障碍的一种理想方法.

Using finger dorsum fascial pedicle island flaps with arteries and nerves to repair finger skin with artery defects

Objective To discuss the method and the curative effect of digital dorsum fascial pedicle island flaps which are retrograde transfered from the same finger and anteragrate transfered from the adjacent fingers with veins and nerves to repair palmar skin defects with digital proper artery and nerve defects.Methods From August 2011 to March 2013,18 cases of palmar skin soft tissues with digital proper artery and nerve defects were repaired by fascial pedicle island flaps with the area of 1.2 cm×1.5 cm～2.5 cm×3.5 cm.Skin-grafting was performed at the wounds of donor sites.Results All 18 cases of flaps survived after operations.The wounds of donor sites healed.After the follow-up of 6 to 12 months,the texture and appearance of flaps were fine.The sensation recovered to S3～S4,and two-point discrimination,to 4～8 mm.Conclusion It＇s easy to operate and safe to bridge without the sacrifice of main vessels in using finger dorsum fascial pedicle island flaps with veins and nerves to bridge and repair the wounded finger with digital proper artery and nerve defects.In addition,the sensation of diatal fingers and flaps can be reconstructed with a small wound of donor site.It＇s an ideal method to repair finger pulp defects and hemodynamic disorders.