CAJ | 학술논문

目的报告应用足背动脉逆行岛状筋膜瓣联合植皮修复甲皮瓣切取后创面的方法及临床疗效.方法对8例拇指套脱伤应用甲皮瓣移植修复后,供区创面缺损面积最大为3.5 cm×6.8 cm,最小为2.5 cm×4.9 cm.以足背动脉足底穿支为旋转点,足背动脉体表投影为轴线,在踝前设计足背动脉岛状筋膜瓣,切取足背动脉周缘筋膜组织,结扎足背动脉近端分支,逆行转移至趾切取后的创面,并在筋膜上植全厚皮片、不打包.结果 8例甲皮瓣、筋膜瓣及植皮创面全部存活,对足部血供无影响.术后随访时间为3～18个月,修复后的趾保留正常长度,外形良好,植皮区无挛缩,恢复保护性感觉,趾屈伸活动及下肢行走正常.结论足背动脉逆行岛状筋膜瓣切取简单,便于旋转,血供丰富,且保留了趾的长度,是修复甲皮瓣切取后遗留创面理想的修复方法.
목적 보고응용족배동맥역행도상근막판연합식피수복갑피판절취후창면적방법급림상료효.방법 대8례무지투탈상응용갑피판이식수복후,공구창면결손면적최대위3.5 cm×6.8 cm,최소위2.5 cm×4.9 cm.이족배동맥족저천지위선전점,족배동맥체표투영위축선,재과전설계족배동맥도상근막판,절취족배동맥주연근막조직,결찰족배동맥근단분지,역행전이지지절취후적창면,병재근막상식전후피편、불타포.결과 8례갑피판、근막판급식피창면전부존활,대족부혈공무영향.술후수방시간위3～18개월,수복후적지보류정상장도,외형량호,식피구무련축,회복보호성감각,지굴신활동급하지행주정상.결론 족배동맥역행도상근막판절취간단,편우선전,혈공봉부,차보류료지적장도,시수복갑피판절취후유류창면이상적수복방법.
Objective To report the method and clinical outcomes of covering big toe defects after wrap-around flap transfer with dorsalis pedis artery reversed fascial island flap combined with skin graft. Methods Wrap-around flap transfer was used to reconstruct degloved thumbs in 8 cases,which left soft tissue defects of the big toe ranging from 2.5 cm×4.9 cm to 3.5 cm×6.8 cm. The reverse fascial island flap pedicled by the dorsalis pedis artery was designed at the anterior ankle with the plantar perforator as pivot point and the surface projection of dorsal pedis artery as axis. The fascia around the dorsalis pedis artery was included in the flap. Proximal branches of the dorsalis pedis artery were ligated and the flap was lifted and rotated to cover the big toe defect. Full-thickness skin was grafted on top of the fascial flap. Results All flaps and skin grafts survived. Blood supply of the foot was not compromised. Postoperative follow-up ranged from 3 to 18 months. The length of the donor big toes was preserved. The contour of toes repaired by flaps was good. There was no contracture of skin grafts. Protective sensation was restored. Walking and motion of the toes was normal. Conclusion Dorsalis pedis artery reversed fascial island flap is easy to harvest and rotate. It has rich blood supply. Transfer of this flap can preserve the length and contour of the big toe and therefore is an ideal method to cover donor site defects left by wrap-around flap harvest.