使用同指动脉岛状皮瓣修复指腹缺损

目的 介绍各种同指动脉岛状皮瓣的手术方法、适应证及疗效。方法 1999年至2003年间，根据指腹缺损类型不同，我们分别采用同指背外侧顺行岛状皮瓣（20例）、同指掌侧顺行岛状皮瓣（10例）、同指指动脉逆行岛状皮瓣（8例）、同指背侧逆行岛状皮瓣（10例）、拇指尺背侧（8例）和桡背侧逆行岛状皮瓣（15例）等多种方法治疗71例75指指腹缺损。结果所有皮瓣顺利存活。71例患者中55例获得4个月以上随访。采用同指指掌侧顺行岛状皮瓣重建的指腹，术后感觉恢复较好，静态两点辨别觉平均5.0mm。而采用吻合神经支的逆行岛状皮瓣重建的指腹，静态两点辨别觉平均9mm。其中2例使用同指指动脉逆行岛状皮瓣重建指腹的患者，术后出现了对冷不耐受等情况。结论 采用同指动脉岛状皮瓣重建指腹，手术一次完成，不损伤正常相邻手指，可恢复一定的感觉功能，是治疗指腹缺损的较好方法。

Homodigital arterialized island flaps for digital pulp loss

Objective To introduce the operative procedure,indications and the treatment result of several kinds of homodigital arterialized island flaps.Methods According to the different type of the digital pulp loss,six kinds of homodigital arterialized island flaps were selected for reconstruction,including the homodigital lateral-dorsal island flaps(20 cases),the homodigital palmar direct-flow island flaps(10 cases),the digital artery reversed-flow island flaps(8 cases),the homodigital dorsal reversed-flow island flaps(10 cases),the thumb ulnar-dorsal(8 cases)and radial-dorsal(15 cases) reversed-flow island flaps.71 cases and 75 finger pulp loss were treated with these methods between 1999 to 2003.Result 55 cases were followed up over 4 months.All of the flaps survived well with good appearance and quality.The mean static two-point discrimination was 5.0mm for the homodigital palmar direct-flow island flaps,and 9 mm for the homodigital dorsal reversed-flow island flaps.Two patients treated with the digital artery reversed-flow island flap complained of pain or cold intolerance.Conclusion The homodigital arterialized island flaps offer a sensate skin flap for one-stage reconstruction of a pulp defect,the techniques are simple,the treatment results are satisfied.It is a good method for reconstruction of the pulp loss.