中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
CHINESE JOURNAL OF PLASTIC SURGERY
2011年
5期
340-342
,共3页
李启朝%张双喜%陈振喜%朱广明%崔浩杰%顾方瑞%卢俊岳
李啟朝%張雙喜%陳振喜%硃廣明%崔浩傑%顧方瑞%盧俊嶽
리계조%장쌍희%진진희%주엄명%최호걸%고방서%로준악
指%指固有动脉%岛状皮瓣
指%指固有動脈%島狀皮瓣
지%지고유동맥%도상피판
Fingers%The digital proper artery%Island skin flap
目的 探索一种修复第2～5指远节皮肤缺损的方法。方法 以指固有动脉中段背侧支为蒂，设计手指中节指背岛状皮瓣。如需重建指腹感觉，在切取皮瓣时，则应于皮瓣近端保留适当长度的指固有神经背侧支（小指为指背神经），以便与伤指指固有神经断端吻合。2005年2月至2010年5月，应用此方法修复54例手指远节皮肤缺损，共61指，其中指腹缺损35指，指端缺损26指。结果 皮肤缺损最大面积2.2 cm ×2.5 cm，皮瓣切取最大面积2.4 cm ×2.7 cm。61指皮瓣全部成活，3指术后2天皮瓣远端出现水泡，未予以处理。术后7d水泡开始萎缩吸收，术后14 d水泡消退，皮瓣成活。54例均获得随访。随访时间5个月～1年10个月，平均11个月。皮瓣质地色泽好，外形良好，指腹较饱满，恢复痛温觉，两点辨别距离6～9 mm。按感觉功能评定标准为S4。患指指间关节活动正常。结论 指动脉中段背侧支岛状皮瓣，是一种较理想的修复远节手指皮肤缺损的方法。
目的 探索一種脩複第2～5指遠節皮膚缺損的方法。方法 以指固有動脈中段揹側支為蒂，設計手指中節指揹島狀皮瓣。如需重建指腹感覺，在切取皮瓣時，則應于皮瓣近耑保留適噹長度的指固有神經揹側支（小指為指揹神經），以便與傷指指固有神經斷耑吻閤。2005年2月至2010年5月，應用此方法脩複54例手指遠節皮膚缺損，共61指，其中指腹缺損35指，指耑缺損26指。結果 皮膚缺損最大麵積2.2 cm ×2.5 cm，皮瓣切取最大麵積2.4 cm ×2.7 cm。61指皮瓣全部成活，3指術後2天皮瓣遠耑齣現水泡，未予以處理。術後7d水泡開始萎縮吸收，術後14 d水泡消退，皮瓣成活。54例均穫得隨訪。隨訪時間5箇月～1年10箇月，平均11箇月。皮瓣質地色澤好，外形良好，指腹較飽滿，恢複痛溫覺，兩點辨彆距離6～9 mm。按感覺功能評定標準為S4。患指指間關節活動正常。結論 指動脈中段揹側支島狀皮瓣，是一種較理想的脩複遠節手指皮膚缺損的方法。
목적 탐색일충수복제2～5지원절피부결손적방법。방법 이지고유동맥중단배측지위체，설계수지중절지배도상피판。여수중건지복감각，재절취피판시，칙응우피판근단보류괄당장도적지고유신경배측지（소지위지배신경），이편여상지지고유신경단단문합。2005년2월지2010년5월，응용차방법수복54례수지원절피부결손，공61지，기중지복결손35지，지단결손26지。결과 피부결손최대면적2.2 cm ×2.5 cm，피판절취최대면적2.4 cm ×2.7 cm。61지피판전부성활，3지술후2천피판원단출현수포，미여이처리。술후7d수포개시위축흡수，술후14 d수포소퇴，피판성활。54례균획득수방。수방시간5개월～1년10개월，평균11개월。피판질지색택호，외형량호，지복교포만，회복통온각，량점변별거리6～9 mm。안감각공능평정표준위S4。환지지간관절활동정상。결론 지동맥중단배측지도상피판，시일충교이상적수복원절수지피부결손적방법。
Objective To explore a method for the treatment of the skin defects at the distal phalanges of 2-5th fingers. Methods The island flap at the dorsum of the middle phalange was designed with the pedicle of dorsal branches from the digital proper artery. When the flap was used to repair defect at finger pulp, the dorsal branch of the digital proper nerve in the flap was kept to be anastomosed to the digital proper nerve at the recipient finger. From Feb. 2005 to May. 2010, 54 cases with skin defects at the distal phalanges of 61 fingers were treated with the flap, including 35 defects at finger pulp and 26 defects at finger tip. Results The maximum size of defects and flaps was 2. 2 cm× 2. 5 cm and 2.4 cm ×2. 7 cm, respectively. 61 flaps survived completely. Blister was happened in 3 flaps 2 days after operation,which healed spontaneously without necrosis. 54 cases were followed up for 5 to 22 months ( average, 11 months). The flaps had good texture and color match with normal sensation (grade S4). The 2-point discrimination distance was 6-9 mm. The interphalangeal joint had normal movement. Conclusions The island flap at the dorsum of the middle phalange is an ideal method for the skin defect at the distal phalange of finger.
