骨间后动脉双叶皮瓣修复手部皮肤缺损的临床应用

目的　探讨骨间后动脉双叶皮瓣修复手部多处或较大面积皮肤软组织缺损的临床疗效。 方法　2011年3月~2018年12月，采用前臂骨间后动脉蒂双叶皮瓣转移修复4例多处皮肤软组织缺损和5例较大面积皮肤软组织缺损，创面均伴深部组织外露。皮瓣切取面积为4.5 cm×5.5 cm~7.0 cm×9.0 cm。供区直接拉拢缝合。 结果　本组皮瓣全部顺利成活。术后4例获得随访，随访时间2个月~2年，平均10个月，2例皮瓣外形臃肿，术后半年予皮瓣整形术。皮瓣质地好，皮色与受区相近，皮瓣两点辨别觉11~20 mm，平均14 mm，腕关节功能无影响。 结论　应用骨间后动脉双叶皮瓣修复手部皮肤缺损，具有不损伤前臂主干血管，血管解剖恒定，切取简便，成活率高，部分患者供区可直接缝合，色泽与质地和受区相近，后期功能良好等优点，是修复手部皮肤缺损的较为理想方法。

Clinical application of posterior interosseous artery bilobate flap in repairing hand skin defect

Objective To investigate the clinical effects of posterior interosseous artery bilobate flap on repairing multiple or large skin and soft tissue defects of the hand.Methods 4 cases of multiple skin and soft tissue defects and 5 cases of large area skin and soft tissue defects,who were treated with forearm posterior interosseous artery bilobate flap transformation from March 2011 to December 2018,were selected.All patients’wounds were accompanied by deep tissue exposure.The cutting area of flap was 4.5 cm×5.5 cm^7.0 cm×9.0 cm in size and the donor area was directly stitched together.Results All flaps survived successfully.Four patients were followed up for 2 months to 2 years,with an average of 10 months.Among them,2 patients had overstaffed flap and underwent flap plasty half a year after operation.The flap had a good texture and the skin color was similar to the recipient area.The two-point discrimination perception of the flap was 11~20 mm,with an average of 14 mm.The wrist joint function was not affected.Conclusions The application of posterior interosseous artery bilobate flap in repairing hand skin defects has the advantages of no damage to forearm main blood vessels,constant vascular anatomy,simple and convenient cutting,high survival rate,direct suture of part of donor site,similar color and texture compared with recipient site,good late function,which was an ideal method to repair hand skin defects.