摘要
随着显微外科和皮肤血循环研究的进展,为手部皮肤缺损提供各种带血管蒂的岛状皮瓣已成为可能,这些岛状皮瓣能用于修复难以修复的断指端和手部皮肤缺损。神经血管蒂三角岛状皮瓣(Kutler改良法、Tranquilli-Leali法和阶梯法),Littler神经血管蒂岛状皮瓣,逆行性血管蒂远位岛状皮瓣,都可用以修复断指端和皮肤缺损。就一些小面积手部皮肤缺损而言,由于损伤的部位和周围皮肤条件的限制,要提供局部皮瓣、远位皮瓣和游离皮瓣是很困难的。根据第1掌背动脉蒂岛状皮瓣(Kiteflap by Foucher),作者用第2、3、4掌背手动脉制作血管蒂岛状皮瓣,并采用了Rose局部动脉岛状皮瓣、逆行性血管蒂小鱼际岛状皮瓣和逆行性大鱼际血管蒂岛状皮瓣,获得了极好的效果。本文还对这些方法的手术技巧、指征和利弊进行了讨论。
Various vascular pedicle island flaps have become possible to repair skin defect of the hand along with the progress of microsurgery and investigation of the blood circulation in the skin.These vascular pedicle island flaps can be used for covering the amputated stump of the finger and skin defect of the hand,which were difficult to cover.For the amputated finger stump and skin defect of the pulp,neu-rovascular pedicle triangular island flap (modified kutler method,modified Tranquilli-Leali method and stepladder method),neurovascular pedicle volar advancement flap (combined method with O' Brien and Macht),neurovascular pedicle island flap by Littler and reverse vascular pedicle digital island flap by the author were used.In certain cases with small areas of skin defects,it is difficult to apply local flaps,distant flaps and free flaps due to the defective site and sourrounding skin conditions.For such cases,kite flap by Foucher,dorsal metacarpal flap by the author using the 2nd,3rd and 4th dosal intermetacarpal vessels.Rose's local arterialized island flap,reverse vascular pedicle hypothenar island flap by the author,and reverse vascular pedicle thenar island flap by the author were used with excellent results.Operative technique,indication,advantages and disadvantages of these methods are described.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
1989年第4期259-264,共6页
Medical Journal of Chinese People's Liberation Army
