摘要
目的探讨采用足底内侧静脉皮瓣游离移植修复指掌侧软组织缺损的方法及近期疗效。方法2007年5月-2009年7月,收治指掌侧软组织缺损13例15指。男7例9指,女6例6指;年龄17～55岁,平均30岁。致伤原因:电锯伤4例5指,压砸伤6例6指,烧伤后指掌侧瘢痕切除创面3例4指。受伤指别:拇指5指,示、小指各3指,中、环指各2指。软组织缺损范围1.0cm×0.9cm～5.8cm×3.3cm。外伤患者受伤至手术时间为2～12h,平均4h;3例瘢痕患者择期手术。术中切取大小为1.0cm×1.0cm～6.0cm×3.5cm足底内侧静脉皮瓣修复缺损,其中12指皮瓣携带1条浅静脉,3指携带2条;13指皮瓣静脉桥接一侧指动脉,2指桥接双侧指动脉。供区创面直接缝合或全厚皮片植皮修复。结果术后皮瓣均顺利成活,创面Ⅰ期愈合。供区切口Ⅰ期愈合,植皮全部成活。11例11指术后获随访,随访时间为2～12个月。皮瓣色泽、质地与周围正常皮肤相似,外观满意;两点辨别觉为6～9mm。手指功能按照总主动活动度/总主动屈曲度标准评定,优10例,良1例,优良率100%。结论足底内侧静脉皮瓣手术操作简便,血运好,成活率高,是修复指掌侧软组织缺损的有效方法之一。
Objective To investigate the operative procedure and the short-term therapeutic effects of medial plantar venous flaps for restoration of soft-tissue defects on the volar aspect of fingers.Methods From May 2007 to July 2009,13 cases （15 fingers）of volar soft tissue defects were treated with medial plantar venous flaps,including 7 males（9 fingers）and 6 females （6 fingers）with an average age of 30 years（range,17-55 years）.Soft tissue defects were caused by electric saws in 4 cases（5 fingers）, by crush injury in 6 cases（6 fingers）,and by burned scar removal in 3 cases（4 fingers）.The size of soft tissue defects ranged from 1.0 cm×0.9 cm to 5.8 cm×3.3 cm,included 5 thumbs,3 index fingers,3 little fingers,2 ring fingers,and 2 middle fingers.The emergency surgical treatment was performed in 10 traumatic cases after 2 to 12 hours（4 hours on average）;and the elective surgical treatment was performed in the other 3 cases of scar after burn.The 15 medial plantar venous flaps,with size of 1.0 cm×1.0 cm to 6.0 cm×3.5 cm,were harvested to restore defects.Of them,12 venous flaps had 1 superficial vein and the other 3 had 2 veins; and the veins of 13 venous flaps bridged a single digital artery and the veins of the other 2 flaps bridged both arteries.The donor sites were sutured directly or were covered with skin graft.Results All 15 venous flaps survived completely,and the donor and recipient sites healed by first intention.Eleven cases（11 fingers）were followed up for 2 to 12 months.The texture and color of the flaps were similar to those of adjacent normal skin with a satisfactory appearance.The two-point discrimination was 6-9 mm. According to criterion for joint junction of total active range of motion/total active range of flexion,the results were excellent in 10 cases and good in 1 case;the excellent and good rate was 100%.Conclusion The medial plantar venous flap has advantages of easy-to-operate,rich blood supply and high survival rate.So it is an ideal and reliable choice for volar soft tissue defects of fingers.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第1期50-52,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
足底内侧静脉皮瓣
指掌侧
软组织缺损
修复
Medial plantar venous flap Palmar digital skin Soft-tissue defect Repair
