掌背动脉皮支蒂逆行筋膜皮瓣修复手指皮肤缺损

目的 评价应用掌背动脉皮支蒂逆行筋膜皮瓣修复手指皮肤缺损的方法及临床疗效.方法 对38例手指皮肤缺损伴指骨或肌腱外露的患者,分别采用第2、3、4掌背动脉皮支蒂逆行筋膜皮瓣进行修复,皮瓣切取面积为2.0 cm×4.5 m～3.0cm×8.0cm.结果 术后38例38指皮瓣全部存活.随访时间为6个月至3年,皮瓣外形优良,不臃肿,两点分辨觉为5～9mm,手指功能恢复良好.供区掌背留有线形瘢痕,少许色素沉着.结论 掌背动脉皮支蒂逆行筋膜皮瓣切取方便,损伤小,不牺牲主干动脉,皮瓣切取范围大,可修复指尖创面,是修复手指皮肤缺损的良好方法.

Dorsal metacarpal artery cutaneous branch reverse fascio-cutaneous flap to repair soft tissue defects of the fingers

Objective To evaluate the method and treatment outcome of repairing soft tissue defects of the fingers with dorsal metacarpal artery cutaneous branch reverse fascio-cutaneous flap. Methods Thirty-eight cases of soft tissue defects of the fingers with bone or tendon exposure were repaired by the application of the second, third or fourth dorsal metacarpal artery cutaneous branch reverse fascio-cutaneous flap. The flap area ranged from 2.0 cm × 4.5 cm to 3.0 cm × 8.0 cm. Results All 38 flaps of the 38 cases survived. The patients were follow-up for 6 months to 3 years. The appearance of the flaps was good. There was no bulkiness.2-PD of the flaps recovered to 5 to 9 mm. The function of the fingers recovered well. Donor site on the dorsum of the hand was closed directly which only led to a linear scar. Slight pigmentation was noticed. Conclusion Dorsal metacarpal artery cutaneous branch reverse fascio-cutaneous flap is an optimal method for coverage of soft tissue defect of the fingers. The surgery is easy and less traumatic. No major artery needs to be sacrificed. The other advantage is that the harvestable area of the flap is large which makes repair of finger tip defects possible.