股前外侧KISS皮瓣修复多个手指背侧软组织缺损

目的探讨股前外侧KISS皮瓣移植修复多个手指背侧软组织缺损的手术方法和临床效果。方法2014年1月至2019年6月,共收治7例多个手指背软组织缺损,其中累及3指者1例,4指者6例。一期手术通过设计手部创面,将多指并指后采用股前外侧KISS皮瓣移植修复,供区直接缝合关闭;二期手术分指同时皮瓣修薄整形。术后定期门诊、电话随访,观察皮瓣的外观、质地、功能及供区情况。结果术后皮瓣全部成活,皮瓣及供区伤口一期愈合,无血管危象发生。7例均获随访3~24(平均12.5)个月,皮瓣色泽好,质地柔软,弹性较好,经二期手术分指后皮瓣修薄整形,外形美观。供区肢体仅留一线形瘢痕,对关节功能无影响。结论通过合理的创面设计,选用供区损伤小、供瓣区能直接缝合的股前外侧KISS皮瓣移植修复多个手指背侧软组织缺损,是一种简单、有效的治疗方法。

Application of KISS anterolateral thigh flap in repairing soft tissue defect of dorsal side of multiple fingers

Objective To evaluate the surgical technique and clinical effect of free KISS anterolateral thigh flap in repairing soft tissue defect of dorsal side of fingers.Methods From January, 2014 to June, 2019, 7 patients with soft tissue defects in dorsal side of multiple fingers were treated. Step one, a KISS anterolateral thigh flap was used and a temporary syndactyly between adjacent affected fingers was created by suture of the digital palmar skin. The donor sites were sutured directly. Step two, a procedure of partial de-bulking and division of syndactyly was followed-up 1-3 months later. All cases were followed-up in observations of appearance, texture, functions and donor site of flaps.Results All flaps survived, and all went through disorders of no blood circulation. The followed-up time were 3 to 24 (average 12.5) months. The flaps had fine appearance, texture and colour. The dorsal aspects of reconstructed fingers demonstrated an aesthetically pleasing effect after the flap de-bulking and division of syndactyly. The donor site only left a linear scar, and the thigh had no functional deficit.Conclusion Free KISS anterolateral thigh flap in repairing defects of dorsal skin in multiple fingers could simplify the operation, shorten operative time and reduce surgical trauma.