逆行掌背动脉皮瓣移位修复手指热压伤创面

目的探讨手指热压伤早期手术失败后应用掌背动脉逆行岛状皮瓣修复的临床疗效。方法选择收治的17例手指热压伤患者,因各种原因导致早期手术创面修复失败,创面大小：1 cm×1.5 cm～3 cm×1.5 cm,均合并有骨外露,应用掌背动脉逆行岛状皮瓣进行修复手术,创面愈合后,强化手指功能锻练。结果术后17例皮瓣全部成活,3例皮瓣术后肿胀,起张力性水疱,1例皮瓣青紫瘀血,经及时处理后,皮瓣得以成活,随访4个月～2年,参照主动活动度（TAM）测定法,患者手指功能分别为：优7例,良6例,可4例,优良率达76.4%。结论应用掌背动脉逆行岛状皮瓣对手指热压伤早期手术失败病例进行修复术,早期强化功能锻练,可较好恢复手指功能。

Application of the Island Flap Based on the Reversed Dorsal Metacarpal Artery in Repairing Patients with Severe Hot Crush Injury of Finger

Objective To investigate the clinical effect of the island flap based on the reversed dorsal metacarpal artery for repairing the fingers with severe hot crush injury,which were for failure operation in early stage. Methods From January 2006 to March 2013,17 patients（ 17 fingers） with finger of severe hot crush injury,which were for failure operation in early stage,were treated with the island flap based on the reversed dorsal metacarpal artery. The area of the defect ranged from 1 cm × 1. 5 cm to 3 cm × 1. 5 cm. Function rehabilitation of finger was provided postoperatively in early stage.Results All of the 17 flaps survived with satisfactory effect. Tense blister occurred in 3 cases and blood stasis occurred in1 case,which were cured after dressing change. The follow-up time was 6 months to 2 years. In the total 17 cases,there were excellent in 7 cases,good in 6,medial in 4,according to total active motion method. The good and excellent rate was 76.4%. Conclusion The island flap based on the reversed dorsal metacarpal artery are adopted to repair severe hot crush injury of finger,which were for failure operation in early stage. Meanwhile early function rehabilitation is combined to achieve good recovery of function and appearance of the hand at the greatest extent.