吻合血管的第二掌背动脉皮瓣修复手指掌侧皮肤伴双侧指固有神经、动脉缺损

目的:探讨吻合血管的第二掌背动脉(second dorsal metacarpal artery，SDMA)皮瓣修复手指掌侧皮肤伴双侧指固有神经、动脉缺损的手术方法及临床疗效。方法:自2017年2月至2019年3月，我们对11例手指掌侧皮肤伴双侧指固有神经、动脉缺损患者采用SDMA皮瓣修复创面，皮瓣近端切断的SDMA与...

Application of the second dorsal metacarpal artery flap with vascular anastomosis for repair of the digital palmar skin defects with bilateral proper digital nerve and artery defects

Objective To explore the surgical method and clinical efficacy of the second dorsal metacarpal artery(SDMA)flap with vascular anastomosis for repair of the digital palmar skin defects with bilateral proper digital nerve and artery defects.Methods From February 2017 to March 2019,11 cases of the digital palmar skin defects with bilateral proper digital nerve and artery defects were repaired by the SDMA flap.The SDMA cut at the proximal end of the flap was anastomosed with the digital proper artery at the distal end of the wound.The superficial branch of radial nerve of the dorsal hand was used to bridge the proper digital nerve,and the blood supply and sensation of the fingertip were reconstructed.Results All the 11 patients were followup for 10 to 18 months with an average of 16 months.One case had partial necrosis of the flap edge and healed after dressing change.The other flaps survived uneventfully.The appearance and texture of the flaps were good.The temperature and color of the pulp of the injured finger were consistent with the surrounding skin.The two-point discrimination of finger pulp skin was 7 to 10 mm with an average of 8.8 mm.According to the evaluation standard of upper limb function of the Society of Hand Surgery of Chinese Medical Association,9 cases were excellent and 2 cases were good.Conclusion The SDMA flap with vascular anastomosis can used to repair the digital palmar skin defects with bilateral proper digital nerve and artery defects.The primary repair of finger defects and reconstruction of peripheral blood supply and sensation of the affected finger were satisfactory.It is a good repair method.