静脉皮瓣在断指再植血管危象探查术中的应用

目的:报告静脉皮瓣在断指再植血管危象中的应用和临床效果。方法:2008年1月至2011年5月,对23例断指再植血管危象的患者采用静脉皮瓣游离移植同时修复栓塞血管及皮肤缺损创面,皮瓣面积为1.5 cm×2 cm～3 cm×4.2 cm,供区直接缝合。结果:断指及皮瓣全部成活,其中4例早期肿胀,有水泡形成,皮瓣为紫红色,经间断拆线后好转。术后随访3～20个月,皮瓣及再植指血运好,优14例,良7例,可2例,优良率为91.3%。结论:在断指再植血管危象探查时因肿胀、感染,皮肤坏死,常伴有皮肤缺损,静脉皮瓣在桥接血管,重建血运的同时还能修复皮肤缺损创面,是一种理想的手术方法。

Application of venous flap in the vascular crisis exploration of finger re-plantation

Objective:To report the application and treatment outcomes of venous flap in the vascular crisis exploration of finger re-plantation.Methods:From January 2008 to May 2011,23 cases of vascular crisis were treated with venous flap.It can repair both the vascular thrombosis and the skin defect.The flap was 1.5cm×2cm～3cm×4.2cm in size.The donor site was directly closed.Results: All the fingers and the flaps survived completely.In 4 cases,there were swelling and vesicle of the flap which healed with conservative management.Postoperative follow-up ranged from 3 to 20 months.The flaps and fingers had good circulation.The results were graded as excellent in 14 cases,good in 7 cases,and fair in 2 cases.The overall excellent rate was 91.3%.Conclusions: In the vascular crisis exploration of finger re-plantation,there are skin defect because of the infection,swelling and skin necrosis.Venous flap can rebuilt the circulation and repair the skin defect.It is an ideal method.