趾部游离皮瓣修复指腹缺损的临床应用

目的 总结应用趾部游离皮瓣修复手指指腹缺损的临床效果.方法 对手指指腹缺损采用第一足趾腓侧或第二足趾胫侧游离皮瓣修复25例,皮瓣切取面积大小为2.0 cm×3.0 cm～3.5 cm×4.5cm,进行趾底动脉.指固有动脉,皮下静脉-指背静脉吻合重建皮瓣血液循环,趾底神经-指同有神经重建感觉.结果 25例皮瓣全部成活,术后出现血管危象2例,行手术探查后重新吻合血管成活,3个月后行皮瓣整形手术12例.术后随访2个月～2年,平均10个月,手指功能与外观均满意,指腹饱满,感觉及运动恢复正常,两点辨别觉为4～6 mm.结论 应用趾部游离皮瓣修复手指指腹缺损可获较好的临床效果.

Toe pulp free flap to repair defects in the clinical application of the fingers

Objective To evaluate the toe flap repair of finger pulp defect of the clinical effects.Methods Of finger pulp defect using the first or second toe in 25 cases of free flaps, the flaps were cut size of 2.0 cm x 3.0 cm-3.5 cm x 4.5 cm, to toe at the end of artery-means the artery, subcutaneous veins-ve-nous anastomosis reconstruction of dorsal skin flap blood circulation, plantar digital nerve-refers to the inherent sensory nerve reconstruction.Results Twenty-five patients with flaps all survived, after vascular crisis occurred in 2 cases,surgical exploration and re-anastomosis of vascular survival, 3 months after flap reconstructive surgery in 12 cases.All patients were followed up for 2 months to 2 years, an average of 10 months,the fingers were satisfied with function and appearance, pulp full, two- point discrimination was 4-6 mm.Conclusion The toe plantar free flap repair of finger pulp defect may be a better clinical effects.