腹部瓦合式皮瓣修复多指中末节套状撕脱伤

目的 介绍腹部瓦合式皮瓣修复多个手指中末节套状撕脱伤的手术方法 .方法 对48例手指中末节套脱伤,采用同侧腹部瓦合式皮瓣进行修复.根据指尖连线的弧形轴线设计连续多个相对的常规皮瓣,皮瓣两两相对瓦合,形成多个皮管,分别套入患指覆盖软组织缺损.各患指指尖间距约2.5～3.0 cm分布在腹部的弧形线上,指间关节自然弯曲,体位较舒适,皮瓣无扭转和过分反折.结果 术后48例瓦合式皮瓣均无坏死,4周行皮瓣蒂部血供阻断试验,5～6周行断蒂术.术后随访6个月至5年,平均18个月.患指屈伸功能基本正常,皮瓣恢复部分粗感觉,外形较满意.结论 采用腹部瓦合式皮瓣治疗多指中末节皮肤套状撕脱伤,手术操作简单,疗效确切.

Repairing multi-finger distal degloving injuries with abdominal tile-gather flap

Objective To introduce the surgical techniques of abdominal tile-gather flap for repairing multi-finger distal degloving injuries.Methods Ipsilateral abdominal tile-gather flap(the Great wall flap)was used to repair multi-finger distal degtoving injuries in 48 cases.According to the arc axis of fingertips,multipte conventional flaps were designed to pair with each other as tile-gather and form several skin tubes to accommodate the degloved fingers.The fingertips were distributed in the curved line with 2.5 to 3.0 cm distance in between.The interphalangeal joints were slightly flexed to ensulre a comfortable posture.Attention was paid to not to twist or fold the flaps. Results Postoperatively there was no necrosis in the 48 tile-gather flaps.The pedicle was clamped 4 weeks postoperatively and divided 5 to 6 weeks postoperatively.Follow-up period ranged from 6 months to 5 years,with an average of 18 months.Flexion and extension of the fingers was near normal.The flaps regained some sensation.The appearance was satisfactory.Conclusion Abdominal tile-gather flap is a simple and reliable procedure to repair multi-finger distal degloving injuries.