桡动脉腕背分支为蒂的手背逆行岛状筋膜皮瓣的临床应用

目的探讨手背部桡动脉腕背分支为蒂的三种逆行岛状筋膜皮瓣的手术方法及临床应用。方法桡动脉在腕背鼻烟窝穿出,与尺动脉掌深弓吻合之前,发出腕背皮支、第1掌背动脉、拇指背侧支以三支动脉为蒂,形成逆行鼻烟窝皮瓣、第1掌背动脉皮瓣、拇指背侧动脉皮瓣,修复虎口挛缩和指、示指、腕掌、腕背侧皮肤缺损。结果切取桡动脉腕背皮支逆行岛状皮瓣13例,修复拇指、虎口、指、腕掌、腕背组织损伤及缺损。术后随访皮瓣外形及手功能恢复效果满意。结论桡动脉腕背分支行岛状筋膜皮瓣血运好,质地柔软,切取方便,不牺牲主要动脉,是修复手部皮肤缺损的一种简单安全、损伤小的方法。

Clinical application of dorsal metacarpal reverse island fasciocutaneous flap pedicled with dorsal carpal branch of radial artery

Objective To explore the surgical technique of applying three types of the dorsal metacarpal reverse island fasciocutaneous flap pedicled with dorsal carpal branch of radial artery. Methods The radial artery sent out from cutaneous branch of dorsal carpal,the first dorsal metacarpal arteries,the dorsal artery of thumb.Supplied by the dorsal carpal branch of the radial artery,we designed three flaps,such as the anatomical snuffbox flap,the dorsal metacarpal reverse flap,the dorsal reverse flap pedicled with dorsal artery of thumb,were designed to repaired soft tissue defect of thumb,index and dorum of hand.Results we have successfully treated13cases with the dorsal metacarpal reverse island flap,and abtained satisfactory results in outline and function.Conclusion It is a simple,safe and less traumatic method for treatment of hand skin defects.