CAJ | 학술논문

目的：探讨尺动脉腕上皮支皮瓣修复手指创面的手术方法及效果。方法对11例手指皮肤软组织缺损合并肌腱或骨外露者，采用游离尺动脉腕上皮支皮瓣进行修复。其中8例面积为2.5 cm×1.0 cm～5.2 cm×2.2 cm的皮瓣，在腕上皮支下行支轴线上切取；3例面积为5.5 cm×3.0 cm～6.2 cm×3.8 cm的皮瓣，在腕上皮支下行支及上行支轴线上切取。皮瓣切取后，8例下行支皮瓣内腕上皮支主干均直接与受区指动脉吻合，3例合并有上行支的皮瓣均移植了前臂静脉与受区的指动脉吻合，皮瓣内的皮下静脉或伴行静脉分别与近端指掌侧或指背侧2～3根静脉吻合，将皮瓣内携带的1条尺神经手背支与指固有神经接合。结果术后11例皮瓣全部成活，并获得4～17个月随访。皮肤弹性、色泽、质地良好，外形满意。两点辨别觉9～12 mm。结论游离尺动脉腕上皮支皮瓣供区隐蔽，血管穿支位置恒定，不损伤主干血管，供区损伤小，切取简单，修复手指缺损外观满意，可携带神经恢复皮瓣感觉，是修复手指创面的一种理想选择。
목적：탐토척동맥완상피지피판수복수지창면적수술방법급효과。방법대11례수지피부연조직결손합병기건혹골외로자，채용유리척동맥완상피지피판진행수복。기중8례면적위2.5 cm×1.0 cm～5.2 cm×2.2 cm적피판，재완상피지하행지축선상절취；3례면적위5.5 cm×3.0 cm～6.2 cm×3.8 cm적피판，재완상피지하행지급상행지축선상절취。피판절취후，8례하행지피판내완상피지주간균직접여수구지동맥문합，3례합병유상행지적피판균이식료전비정맥여수구적지동맥문합，피판내적피하정맥혹반행정맥분별여근단지장측혹지배측2～3근정맥문합，장피판내휴대적1조척신경수배지여지고유신경접합。결과술후11례피판전부성활，병획득4～17개월수방。피부탄성、색택、질지량호，외형만의。량점변별각9～12 mm。결론유리척동맥완상피지피판공구은폐，혈관천지위치항정，불손상주간혈관，공구손상소，절취간단，수복수지결손외관만의，가휴대신경회복피판감각，시수복수지창면적일충이상선택。
Objective To explore the methods and efficacy of repairing finger wound by ulnar artery wrist cutaneous branch flap. Methods Using free ulnar artery flap to repair 11 cases of finger skin and soft tissue defect associated with tendon or bone exposed. 8 cases were cut on the wrist cutaneous branch descending branch of the axis, of which an area of 2.5 cm ×1.0 cm~5.2 cm ×2.2 cm. 3 cases were cut on the wrist cutaneous branch of the descending branch and the ascending branch of axis, of whichan area of 5.5 cm × 3.0 cm~6.2 cm ×3.8 cm. Wrist cutaneous branch trunk arteries were anastomosed directly with the digital artery of donor site in 8 cases within the downlink flap, transplantation forearm vein were anastomosed with the digital artery of donor site in 3 cases of ascending branch flap. The subcutaneous veins within the flap or accompanying veins were anastomosed with proximal palm side or dorsal 2~3 root vein, an ulnar nerve dorsal branch with in flap was anastomosed with proper digital nerve. Results 11 flaps all survived after operation, and followed up for 4 to 17 months, it obtained satisfactory elasticity, color, good texture, shape, two-point-discrimination attened to 9~12 mm. Conclusion It is an ideal choice that freeing ulnar artery wrist cutaneous branches flap, for its hidden donor site, constant location of vascular perforating branches, without damaging the main vessel, the small damage for the donor site, a simple cut, good appearance, may carry nerve.