桡动脉穿支蒂岛状皮瓣修复腕及前臂创面

目的 探讨桡动脉穿支蒂岛状皮瓣的解剖以及修复腕及前臂创面的手术方法和临床疗效.方法 以桡动脉搏动及体表投影为中心,采用多普勒血管仪探测桡动脉穿支的部位,以靠近缺损创面部的皮支作为血管蒂及旋转点,根据缺损创面大小、形状设计皮瓣,修复腕及前臂创面12例.结果 术后12例皮瓣中有2例出现静脉危象,经拆除部分缝线后存活,创面愈合,其余10例皮瓣均顺利存活.随访时间3～18个月,皮瓣质地软,外形及功能满意.结论 桡动脉穿支在桡骨茎突近端2.0cm、4.0～ 5.0 cm、7.0cm处较恒定,以此为蒂的岛状皮瓣血供可靠,操作简单,不损伤主干血管,修复后外形好,是修复腕及前臂皮肤软组织缺损的有效方法之一.

Radial artery perforating branch island flap for repair of defects of the wrist and forearm

Objective To discuss the operative method and clinical results of the radial artery perforating branch island flap.Methods The radial artery perforating branch island flap was used to repair defects of the wrist and forearm in 12 cases.Radial artery pulse and surface projection was used as the centre to probe the cutaneous perforating branches with Doppler ultrasonography.The perforator that was close to the defect was chosen as the vascular pedicle and pivoting point of the island flap.The flap was designed based on the size and shape of the defect to repair the wound of the wrist and forearm.Results Vein crisis occurred in 2 cases of 12patients.The 2 flaps partially survived after removing the sutures.The rest 10 flaps survived uneventfully.After 3 to 18 months' follow-up,the texture of the flap was found to be soft and the shape and function satisfactory.Conclusion The perforating branch of the radial artery was relatively constant at 2 cm,4 to 5 cm and 7 cm above radial styloid process.Island flaps with pedicles of these perforators have reliable blood supply.Flap harvesting is simple,without damaging the main vessel.Postoperative appearance is good.This flap is an effective method to repair soft tissue defects of the wrist and forearm.