摘要
目的探讨游离分叶骨间背动脉皮瓣修复多指皮肤缺损的临床应用效果。方法对2～4指皮肤缺损，根据各指创面相隔距离的远近，采用骨问背动脉不同区域的皮支组合，设计以骨间背动脉为蒂的分叶皮瓣进行修复。2指皮肤缺损：采用游离双叶骨间背动脉皮瓣修复10例20指；3指皮肤缺损：采用游离三叶骨间背动脉皮瓣修复2例6指；4指皮肤缺损：采用双侧游离双叶骨间背动脉皮瓣修复1例4指。皮瓣切取面积10．0cm×3．5cm～3．0cm×2．5cm，受区吻合血管为近节指固有动脉和指背静脉。结果术后13例29指皮瓣全部顺利存活，1指皮瓣尖端少许坏死，换药后愈合。术后随访6～22个月，平均12．2个月，皮瓣颜色、质地好，10例外形美观，3例较臃肿，10指皮瓣缝合皮神经后两点分辨觉恢复至10～15mm。前臂供区运动功能均无影响。结论游离分叶骨间背动脉皮瓣修复多指皮肤缺损可以获得较好的近期疗效。
Objective To present the clinical outcomes of transferring free lobulated posterior interosseous artery flap for coverage of multi- finger soft tissue defects. Methods According to the distance between the defects of the 2 to 4 digits, the posterior interosseons artery lobulated flap was designed by combining cutaneous branches of different regions. Bilobular flaps were applied for soft tissue reconstruction of 2-finger skin defects in 20 fingers of 10 patients. Trilobular flaps were applied in 6 fingers of 2 patients with 3-finger soft tissue defects. Two bilobular flaps were applied for reconstruction of 4-finger soft tissue defects in 4 fingers of 1 patient. The size of the flaps ranged from 10 cm ~ 3.5 cm to 3 cm ~ 2.5 cm. The vessels for anastomosis at the recipient area were proper digital artery and dorsal digital vein at the proximal level of the finger. Results The flaps in 29 fingers survived completely. Necrosis at the tip of the flap occurred in 1 finger which healed by dressing changing. Postoperative follow-up period ranged from 6 to 22 months, the average being 12.2 months. The color and texture of the flaps were good. The flaps in 10 cases were thin while flaps in 3 cases were a bit thick. Two- point discrimination recovered to 10 to 15 mm （mean, 12.9 mm） in 10 fingers where the cutaneous nerve was included in the flap and sutured. There was no impairment of motor function of the forearm donor site. Conclusion Transfer of free lobulated posterior interosseous artery flap is a valuable option for reconstruction of multi-finger soft tissue defects. It can achieve cosmetically and functionally acceptable results with low morbidity on the donor site.
出处
《中华手外科杂志》
CSCD
北大核心
2014年第1期50-52,共3页
Chinese Journal of Hand Surgery
关键词
外科皮瓣
指损伤
显微外科手术
骨间背动脉
Surgical flaps
Finger injuries
Microsurgery
Posterior interosseous artery
