足趾侧方双叶皮瓣修复手指环形皮肤软组织缺损

目的报道第1，2足趾侧方双叶皮瓣修复手指环形软组织缺损的手术方法和疗效。方法自2005年以来，应用游离的第1，2趾侧方双叶皮瓣瓦合修复手指环形皮肤缺损56例，其中以第1跖背动脉为血管蒂40例，以第1趾底总动脉为血管蒂16例，皮瓣切取面积为第1趾趾侧背皮瓣6．Ocm×3．Ocm-3．Ocm×2．Ocm，第2趾趾侧背皮瓣4．Ocm×2．5cm-3．0cm×2．0cm。单纯修复创面27例，修复创面并桥接再植29例。结果56例皮瓣和桥接再植病例全部成活。术后随访1-3年，皮瓣肤色红润，质地良好，手指外形满意。按手功能评定标准评定：优27例，良21例，优良率达85．7％。结论第1，2趾侧方皮瓣修复手指环形皮肤软组织缺损是理想的手术方法。

Repair of circle shape soft tissue defect of digits by double foliated pulp flaps from the great and 2nd toe

objective To report the operation method and clinical application of double foliated pulp flaps from the great and 2nd toe, for the repair of circle shape soft tissue defect of digits. Methods From 2005, 56 cases with circle shape soft tissue defect of digits were treated by free combined double foliated pulp flaps from the great and 2nd toe. Male in 38 cases, female in 18 cases. Index finger 23 cases, middle finger 21 cases, ring finger 8 cases, small finger 4 cases. Based on the pedicle of the first dorsal metatarsal vessels in 40 cases, deep planter artery in 16 cases, the size was 6.0cm×3.0cm-3.0cm×2.0cm from the great toe and 4.0cm×2.5cm-3.0cm×2.0cm from the 2nd toe. Simple repair 27 cases, bridging transfer 29 cases. Results All cases survived. After 1-3 year follow up, the repaired pulps had excellent appearance with a normal color and consistency. Excellent in 27 cases, good in 21 cases, the excellent and good rate was 85.7%.Conclusion The lateral double foliated pulp flaps from the great and 2nd toe transplantation is an optional therapy for circle-shape soft tissue defect of digits.