摘要
目的探讨逆行切取法游离大鱼际区微型穿支皮瓣修复指掌侧皮肤软组织缺损的可行性。方法自2010年10月至2016年10月，共收治指掌侧软组织缺损共7例7指．男5例5指．女2例2指。年龄17-56岁，平均35岁。1例为砂轮磨伤，1例为机器绞伤，5例为重物砸伤，均伴不同程度的指骨及肌腱外露，创面面积为1．3cm×2．0cm～2．2cm×5．0cm。根据大鱼际区动脉血供的来源不同．设计以3种来源穿支为蒂的大鱼际区游离微型穿支皮瓣修复缺损创面。在大鱼际中部设计皮瓣，皮瓣宽度控制在2．5cm内，以便供区直接缝合。术后定期随访。结果7例皮瓣全部成活，皮瓣面积为1．5cm×2．4cm～2．5cm×5．5cm。术后随访3～17个月（平均9个月）。皮瓣外观及皮肤质地接近指掌侧皮肤，具有清晰的指纹，两点辨别觉为9-15mm，感觉恢复至S33例，S44例。供区外观遗留线性瘢痕。结论逆行切取法游离大鱼际区微型穿支皮瓣修复指端缺损。具有功能外观良好、供区损伤小等优点，但是需要精湛的显微外科技术。
Objective To explore the feasibility of repairing the skin and soft tissue defect at finger palm side with the reversed free thenar mini-perforator flaps. Methods From October, 2010 to October, 2016, 7 patients were treated with reversed free thenar mini-perforator flap to repair skin and soft tissue defects at finger palm side, includ- ing 5 males and 2 females, which the age were between of 17 and 56 （average, 35 years old）. Cause of injury： 1 case of abrasive wear, 1 case of machine twist injury, and 5 cases of heavy injury. All cases with varying degrees of phalanx and tendon exposed. The wound size was from 1.3 cm × 2.0 cm to 2.2 cm × 5.0 cm. According to the origin of the artery in the thenar area, 3 kinds of reversed free thenar mini-perforator flaps were designed to repair the defective wound. In the middle of the large fish, the width less than 2.5 cm perforating flap was designed, so that the area can be directly sutured. Results All 7 flaps survived. The flap size was from 1.5 cm× 2.4 cm to 2.5 cm × 5.5 cm. All patients were followed-up from 3 months to 17 months （average, 9 months）. The appearance and skin texture of flaps was close to the normal finger palm side of the skin, with a clear fingerprint. Two-point discrimination was between 9 mm and 15 mm. The sensory recovery to S3 in 3 cases, S4 in 4 cases. Linear scars were left in the donor areas, with no discomfort. Conclusion This technique has the advantages of good appearance, such as good appearance and small damage to the donor area. However, the surgeon is required the super microscopic techniques.
作者
王成
刘金伟
郑有卯
郑卜真
易利奇
顾仕林
Wang Cheng;Liu Jinwei;Zheng Youmao;Zheng Bozhen;Yi Liqi;Gu Shilin(Department of Hand and Food Surgery, Enze Medical Center （Group） Enze Hospital, Taizhou, Zhejiang Province 318000, China)
出处
《中华显微外科杂志》
CSCD
北大核心
2018年第3期209-212,共4页
Chinese Journal of Microsurgery
基金
浙江省自然科学基金（LGF18H060013）
