手部神经血管蒂皮瓣的临床应用

我院自１９６２年５月至１９９２年１月，应用手部神经血管蒂皮瓣７２例，其中指神经血管蒂皮瓣３８例，示指背侧岛状皮瓣（第Ⅰ掌骨背动脉）２４例，手背第Ⅱ掌骨背动脉皮瓣７例，小鱼际皮瓣３例，修复手部皮肤缺损。术后除１例指神经血管蒂皮瓣失败外，余均成活，经１个月～１２年随访功能优良率为９４．４％。我们在文中介绍了各种皮瓣的优缺点，皮瓣设计，手术要点，并讨论了皮瓣的解剖学规律及手术适应证。

Clinical application of neurovascular island flap in the hand

From 1962 to 1992, four kinds of neurovascular island flaps of the hand were used for the treatment of skin defects in the hand in 72 cases. Of these flaps,38 were pulp flaps of the finger, 24 were based on the first dorsal metacarpal artery, 7 were from second dorsal metacarpal artery and 3 were from hypothenar area. All the flaps survived except 1. Postoperative follow-up showed excellent or good results in 94. 4%. The indications of the operation, flap design and surgical procedure are described. The anatomical feature, the advantages and disadvantages of the flap are discussed.