摘要
目的探讨骨间后Flow-through穿支皮瓣修复手指近、中节软组织缺损的临床疗效。方法自2016年1月至2019年12月,深圳市中西医结合医院手外科对收治的9例手指近、中节皮肤软组织缺损的患者采用骨间后Flow-through穿支皮瓣修复,供区皮瓣设计在前臂中段背侧,皮瓣切取面积为3.0 cm×2.0 cm~6.5 cm×2.5 cm,供区均直接缝合。皮瓣移植至创面后,皮瓣内携带的骨间后动脉主干桥接指掌侧固有动脉,术后观察皮瓣成活情况及手指血供,随访观察皮瓣外观、感觉功能恢复情况等。结果9例患者的骨间后Flow-through穿支皮瓣全部成活,伤口均一期愈合,手指血供良好,无血管危象发生。随访6~12个月,皮瓣外形良好,无臃肿,前臂供区仅留线状瘢痕,皮瓣的两点辨别觉为14~20 mm,平均18 mm。结论骨间后Flow-through穿支皮瓣的动脉管径与手指指动脉匹配,良好修复软组织缺损的同时又不牺牲主干血管,还可以修复长段的指动脉缺损,是一种修复手指近、中节软组织缺损的较理想方法。
Objective To explore the clinical efficacy of posterior interosseous flow-through perforator flap in the repair of soft tissue defects in the proximal and middle segments of fingers.Methods From January 2016 to December 2019,9 patients with skin and soft tissue defects in the proximal and middle segments of fingers were repaired by posterior interosseous flow-through perforator flap.The flap of donor area was designed at the dorsal side of the middle segment of forearm.The resection area was 3.0 cm×2.0 cm to 6.5 cm×2.5 cm.The donor area was directly sutured.After the flap transplanted to the wound,the proper palmar artery of the finger was bridged by the posterior interosseous artery in the flap.The survival of flap and blood supply of finger was observed after operation.The appearance of flap and recovery of sensation and function was observed during the follow-up.Results In 9 patients,all posterior interosseous flow-through perforator flaps survived.The wounds healed in the first stage and the blood supply of fingers was good.No vascular crisis occurred.All patients were followed-up for 6 to 12 months.The appearance of flap was good.No thickening of flap was found.Only linear scar was left in the donor area of forearm.The two-point discrimination of flaps was 14 to 20 mm,with an average of 18 mm.Conclusion The artery diameter of posterior interosseous flow-through perforator flap was matched to the artery diameter of finger.The soft tissue defects can be repaired without sacrificing the main artery.It is an ideal method to repair the defects in the proximal and middle segments of fingers.
作者
叶学浪
黄珊
周望高
张振伟
余少校
李东扬
林慧鑫
柯于海
YE Xue-lang;HUANG Shan;ZHOU Wang-gao;ZHANG Zhen-wei;YU Shao-xiao;LI Dong-yang;LIN Hui-xin;KE Yu-hai(Department of Hand Surgery,Shenzhen Hospital of Integrated Traditional and Western Medicine,Shenzhen 518104,China)
出处
《中国美容整形外科杂志》
CAS
2021年第7期388-390,403,共4页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
骨间后动脉
穿支皮瓣
手指损伤
修复
软组织缺损
Posterior interosseous artery
Perforator flap
Finger
Repair injury
Soft tissue defects
