CAJ | 학술논문

目的探讨应用足底内侧静脉皮瓣修复手指不同部位皮肤软组织缺损的手术方法及临床效果. 方法 2010年3月-2012年4月应用游离足底内侧静脉皮瓣修复手指不同部位创面29例(31指),其中指端缺损11例(13指),指背缺损7例(7指),指腹缺损11例(11指).缺损范围1.2cm×1.5cm～2.5cm×3.5cm.术中切取大小1.5 cm×2.0 cm～3.0 cm ×4.0 cm足底内侧静脉皮瓣修复缺损.供区全部采用全厚皮片植皮. 结果术后皮瓣全部成活.1例皮瓣术后出现动脉危象,2例皮瓣出现静脉危象,予以及时探查,重新吻合动静脉后皮瓣成活.创面Ⅰ期愈合.供区切口Ⅰ期愈合,植皮全部成活.24例26指(5例失访)术后随访4～12个月,指背外形满意,皮瓣色泽、质地与周围正常皮肤相似.指端及指腹缺损修复后有指纹,恢复保护性感觉.结论应用足底内侧静脉皮瓣修复手指皮肤软组织缺损成活率高,术后效果好,是修复手指皮肤软组织缺损的一种较理想方法.
목적 탐토응용족저내측정맥피판수복수지불동부위피부연조직결손적수술방법급림상효과. 방법 2010년3월-2012년4월응용유리족저내측정맥피판수복수지불동부위창면29례(31지),기중지단결손11례(13지),지배결손7례(7지),지복결손11례(11지).결손범위1.2cm×1.5cm～2.5cm×3.5cm.술중절취대소1.5 cm×2.0 cm～3.0 cm ×4.0 cm족저내측정맥피판수복결손.공구전부채용전후피편식피. 결과 술후피판전부성활.1례피판술후출현동맥위상,2례피판출현정맥위상,여이급시탐사,중신문합동정맥후피판성활.창면Ⅰ기유합.공구절구Ⅰ기유합,식피전부성활.24례26지(5례실방)술후수방4～12개월,지배외형만의,피판색택、질지여주위정상피부상사.지단급지복결손수복후유지문,회복보호성감각.결론 응용족저내측정맥피판수복수지피부연조직결손성활솔고,술후효과호,시수복수지피부연조직결손적일충교이상방법.
Objective To investigate procedures and clinical effects of medial plantar venous flaps in reconstruction of different sites of finger soft tissue defects.Methods From March 2010 to April 2012,29 cases (31 fingers) of soft tissue defects in different sites were treated with medial plantar venous flaps,including 11 finger tip defects (13 fingers),7 finger back defects (7 fingers),11 finger pulp defects (11 fingers).Size of the defects ranged from 1.2 cm× 1.5 cm to 2.5 cm × 3.5 cm.Size of the flap ranged from 1.5 cm × 2.0 cm to 3.0 cm × 4.0 cm.Donor sites were covered with full thickness skin graft.Results ALL flaps survived,except for one with arterial crisis and two with venous crisis,which were cured after timely vascular exploration and arteriovenous anastomosis.Donor and recipient sites were healed by first intention and skin grafts in donor sites survived.Twenty-four cases (26 fingers) were followed up for 4 to 12 months.Texture and color of the flaps were similar to those of adjacent normal skin,with a satisfactory appearance.Fingerprint and protective sensation were attained for soft tissue defects of the finger tip and pulp after operation.Conclusion Medial plantar venous flap is an ideal surgical option for reconstruction of finger soft tissue defect,for it has advantages of good effect and less damage to donor sites.