吻合指神经背侧支的指动脉逆行岛状皮瓣修复末节手指指腹缺损

目的探讨总结吻合指神经背侧支的指动脉逆行岛状皮瓣在修复末节手指指腹缺损中的治疗效果。方法对14例15指末节手指指腹缺损的病例使用指动脉逆行岛状皮瓣进行修复,修复过程中仔细解剖同侧指固有神经近节背侧分支中较粗大的分支,将背侧分支的近端与缺损创面对侧指固有神经的远端吻合,修复指腹创面的同时修复缺损的感觉。结果所有指动脉逆行岛状皮瓣成活,经8～12个月的随访,修复的指腹外形饱满,外观好,皮肤耐磨,两点辨别觉在5mm左右,指腹感觉在达S3以上。结论吻合神经的指动脉逆行岛状皮瓣修复末节手指指腹缺损的方法优于其他修复方法。

Reversed digital artery island skin flap with dorsal branch of proper digital nerve for repair of finger pulp defect

Object To explore the effect of reversed digital artery island flap with dorsal terminal branch of proper digital nerve on the repair of finger pulp defect.Methods 14 cases,15 fingers pulp defect were repaired with reversed digital artery island flap.During the operations,the bigger dorsal terminal branches of proper digital nerve were dessected carefully and anatstomosed with opposite injured digital nerve.The finger pulp skin defect was repaired as while as feeling was repaired at the same time.Results All reversed digital artery island flaps survived.After 8-12 months follow up,the repaired finger pulps were healed with good appearance and wearable,the sense discrimination of two-point reached 5 mm,and the sense of the repaired pulp came to S3.Conclusion the operation of applied anastomosis of reversed digital artery island flap with dorsal branch of proper digital nerve for repair of finger pulp defect has a better results than traditional method that without anastomosed nerves.