跖底动脉皮瓣逆行转移修复趾皮肤缺损

目的探讨趾外伤或再造后皮肤缺损使用带蒂皮瓣修复的临床应用价值。方法 2003年9月～2009年9月用跖底动脉皮瓣逆行转移修复趾皮肤缺损21例。在足底设计以跖底动脉为蒂的跖底动脉皮支穿出点为中心的逆行皮瓣修复趾皮肤缺损,设计的跖底皮瓣宽度均小于3cm,供区可以直接缝合。再造时足部供区切取的面积较大,用跖底皮瓣修复趾骨外露创面,其余部分配合植皮。结果 21例跖底动脉皮瓣全部成活,8例外伤和4例Ⅰ度指尖缺损再造的趾供区直接用跖底皮瓣修复,9例拇甲瓣供区配合植皮。供区修复后外形良好,不需要二期整形。结论跖底动脉皮瓣逆行转移修复趾皮肤缺损,皮瓣薄、有神经支配、解剖位置恒定,是修复趾端小面积皮肤缺损的好方法。

Hallux Cutaneous Defect Repair With Reversed Plantar Metatarsal Artery Flap

Objective To explore the repair method for hallux cutaneous defect.Methods From September 2003 to September 2009,we treated totally 21 cases of hallux cutaneous defect by using reversed plantar metatarsal artery flap which centered at the perforating site of the cutaneous branch of plantar metatarsal artery,with the donor site being directly sutured（the flap was less than 3 cm in width）.Results All of the 21 cases of plantar metatarsal artery flap survived with satisfying cosmetic outcomes without needing subsequent reshaping.In the 8 patients with trauma and 4 patients with degree I defect of the finger tip,metatarsal flap was used;in 9 cases,thumb flap was employed.Conclusions Due to the advantages of thinness,nerve nourishing,and constant anatomical position,plantar metatarsal artery flap can be an ideal choice for repairing small dimensional cutaneous defect on the tip of toes.