摘要
目的探讨同指带指神经血管蒂顺行岛状皮瓣移位修复指腹缺损的手术效果。方法2003年11月~2005年2月,30例32指指腹缺损患者,男25例,女5例。年龄18~56岁。创面经彻底清创,应用抗生素治疗2~8d后行同指带指神经血管蒂顺行岛状皮瓣移位修复。缺损范围为1.5cm×1.2cm^3.5cm×2.1cm。皮瓣设计在同指的尺背侧或桡背侧,皮瓣远端距甲根不<5mm,避免损伤甲基质,近端不超过中节指横纹,腹侧切口不超过手指中线,背侧切口不超过手指背中线。切取皮瓣范围为2.0cm×1.5cm^4.0cm×2.5cm。供区创面切取上臂内侧带真皮下血管网皮片植皮。结果术后30例32个皮瓣全部成活,未发生血管危象。25例获随访2~8个月。皮瓣质地血运良好,外形满意,两点辨别觉7~10mm,手指伸展、屈曲活动功能基本正常。结论同指带指神经血管蒂顺行背侧方岛状皮瓣移位,手术方法简便、安全,效果满意,是修复拇、手指指腹缺损的一种较好方法。
Objective To observe the clinical effects of neurovascular island flap from the same finger for repairing pulp defect. Methods From November 2003 to February 2005, 32 pulp defects in 30 cases were covered with neurovascular island flap from the same finger. There were 25 males and 5 females. The age ranged from 18 to 56 years. The operation was performed after debridement and 2 8 days antibiotics therapy. The defect area ranged from 1.5 cm× 1.2 cm to 3.5 cm × 2.1 cm. The flap was harvested on the dorsal part of the finger ularly or radially. The distal end of the flap should be more than 5 mm away from the nail base to avoid nail injury. The ventral and dorsal cut should not exceed the middle line respectively. The flap size ranged from 2.0 cm× 1.5 cm to 4.0 cm×2.5 cm. The donor site was covered with flap of subdermal vascular plexus from the medial side of the upper arm. Results All 32 transferred flaps survived after operation. There was no vascular crisis. Twenty-five cases were followed up from 2 to 8 months. The flaps had good appearance and texture and blood circulation. Two-point discrimination was 7-10 mm. The function of finger motion was returned to normal. Conclusion Transfer of neurovascular island flap from the same finger offered a sensational skin flap for reconstruction of pulp defect. The technique was simple, and the clinical result was satisfactory. It is an ideal method for reconstruction of thumb or finger pulp defects.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2006年第7期725-727,共3页
Chinese Journal of Reparative and Reconstructive Surgery
基金
上海市宝山区科技发展基金资助项目(03-A-32)
关键词
岛状皮瓣
同指
指腹缺损
修复
Island flap Same finger Finger pulp defect Repair
