游离指固有动脉背侧支皮瓣修复指腹缺损

目的 报告应用指固有动脉背侧支皮瓣游离移植修复指腹缺损的手术方法和临床效果.方法 对6例6指指腹缺损的患者,采用指固有动脉背侧支皮瓣游离移植修复,皮瓣切取面积为1.0cm×1.0cm～2.0 6m×2.5 cm,供区为患指或邻指的近节桡背或尺背侧,供区全部采用全厚皮片植皮.结果 术后6例皮瓣全部存活,随访时间6～18个月,平均12个月,皮瓣质地、外形满意,手指功能恢复优良,远指间关节活动度为0°～60°,皮瓣两点分辨觉为6～11mm.皮瓣供区创面Ⅰ期愈合,远期随访植皮区耐磨,无破溃发生,供区指体活动未受影响.结论 应用游离指固有动脉背侧支皮瓣修复指腹缺损,手术操作相对简单,修复后指腹饱满、外形逼真并具有感觉,是一种理想的手术方法.

Repair of finger pulp defect using free digital artery dorsal branch flap

Objective To introduce the techniques of using free digital artery dorsal branch flap to repair finger pulp defect, and evaluate the clinical outcomes. Methods Free digital artery dorsal branch flap was transferred to repair finger pulp defect in 6 fingers of 6 patients. The area of flaps ranged from 1.0 cm× 1.0 cm to 2.0 cm× 2.5 cm. The donor sites were dorsoradial or dorsoulnar aspect of the proximal phalanx of the injured finger or the adjacent finger. The donor areas were covered with full-thickness skin graft. Results All 6 flaps survived postoperatively. Follow-up period ranged fiom 6 to 18 months, with an average of 12 months. The texture and appearance of the flaps were satisfactory. Finger function recovery was good, with 0° to 60° range of motion of the distal interphalangeal joint. Two-point discrimination of the flaps was 6 to 11 mm. Primary healing was achieved in the donor area wound. Long-term follow up showed that the skin grafts were wearable. There was no ulceration, and the movement of the donor finger was not impaired. Conclusion Free digital artery doral branch flap transfer is an ideal procedure for repair of finger pulp defect. The technique is relatively straightforward. The reconstructed finger pulp is full, aesthetic and sensate.