带神经的同指螺旋状顺行岛状皮瓣修复指端缺损

目的 探讨带神经的同指螺旋状顺行岛状皮瓣修复指端缺损的手术效果.方法 2007年3月至2009年6月,对15例指端缺损的患者,在清创术后3～6 d,采用带神经的同指螺旋状顺行岛状皮瓣进行修复.指端皮肤缺损面积为1.5 cn×1.2 cm～2.2 cm×2.0 cm.供区中节指背创面取前臂内侧全厚皮片植皮修复.结果 术后15例皮瓣均未发生血管危象,皮瓣与皮片全部存活.15例随访时间为6～24个月,患指伸、屈功能正常,伤指无疼痛,皮瓣外形满意、质地柔软、有指纹,末节指端静止两点分辨觉为5～6 mm,指侧方静止两点分辨觉为8～10 mm.结论 带神经的同指螺旋状顺行岛状皮瓣修复指端缺损,手术方法简单、可靠,效果满意,是修复指端缺损的一种理想的手术方法.

Transfer of neurovascular island spiral flap from the same finger for repairing fingertip defects

Objective To observe the clinical effects of neurovascular island spiral flaps from the same finger for repairing fingertip defects. Methods From March 2007 to June 2009, 15 cases of fingertip defects were treated with neurovascular island spiral flaps from the same finger 3 to 6 days after debridement. The defect area ranged from 1.5 cm × 1.2 cm to 2.2 cm × 2.0 cm. The donor site on the dorsum of the middle phalanx was covered with full-thickness skin graft from the medial side of the upper arm. Results All 15 transferred flaps and skin grafts survived after the operation. There was no vascular crisis. All 15 cases were follow-up for 6 to 24 months. Flexion and extension of the fingers returned to normal range. There was no pain in the fingers. The flaps had good appearance, texture and blood circulation. Static two-point discrimination of the pulps was 5 to 6 mm, of the lateral side of the fingers 8 to 10 mm. Conclusion Transfer of neurovascular island spiral flap from the same finger offered a sensational skin flap for reconstruction of fingertip defects. The technique was simple, and clinical result was satisfactory. It is an ideal method for reconstruction of fingertip defects.