足部一蒂多瓣同时修复手部多处皮肤缺损

目的 介绍足部一蒂多瓣同时修复手部多处皮肤缺损的临床效果.方法 对8例19处手部创面采用一蒂多瓣的方法进行修复,其中以第一跖底动脉为蒂的第一、二趾侧方皮瓣修复5例12处；以足背动脉为蒂的跗外侧皮瓣及第一、二趾侧方皮瓣修复1例3处；以足背动脉为蒂的足背皮瓣及(足母)趾趾腹皮瓣修复2例4处.结果 术后8例19块皮瓣全部存活,随访时间为3～ 36个月,皮瓣外形逼真,两点分辨觉为5～11 mm,有排汗功能,术后供区植皮创面Ⅰ期愈合.结论 足部一蒂多瓣是同时修复手部多个创面的理想方法,它简化了手术步骤,缩短了手术时间,但应根据损伤类型、面积选择最合适的皮瓣.

Multiple flaps based on one pedicle from the foot to repair multiple skin defects of the hand

Objective To introduce the clinical outcomes of using multiple flaps based on one pedicle from the foot for repairing multiple skin defects of the hand.Methods Eight cases with a total of 19 wounds of the hand were treated with multiple flaps based on one pedicle from the foot.The lateral flaps from the first and second toes based on first plantar metatarsal artery were used to repair 12 wounds in 5 cases.Lateral tarsal flap and the first and second toes lateral flaps based on dorsalis pedis artery were transferred to repair 3 wounds in 1 case.Foot dorsum flap and big toe pulp flap pedicled on dorsalis pedis artery were used to repair 4 wounds in 2cases.Results All 19 flaps in 8 cases survived.Postoperative follow-up periods ranged from 3 to 36 months.Flap appearance was lifelike.Two-point discrimination was 5 to 11 mm.Sweat function recovered.Primary healing of skin grafts was achieved at the donor sites. Conclusion Transfer of multiple flaps based on one pedicle from the foot is an ideal method to repair multiple defects of the hand.It simplifies the surgical procedure and shortens the operation time.Flap selection should be based on the type and area of the injury.