CAJ | 학술논문

目的介绍吻合血管的骨间背穿支皮瓣修复手指皮肤缺损的临床方法和经验.方法 2006年5月至2011年5月对29例手指皮肤软组织缺损患者行术前彩色B超定位,术中采用不携带深筋膜的骨间背穿支皮瓣进行修复,吻合骨间背动脉与指固有动脉、皮下浅静脉与指背静脉,并可吻合骨间背静脉及手指掌侧静脉.结果术后27例皮瓣存活,随访6～ 12个月,皮瓣质地优良,外观比较满意；2例皮瓣出现静脉危象,1例完全坏死,1例部分表皮坏死.结论吻合血管的骨间背穿支皮瓣是一种修复手指皮肤缺损的较好方法.
목적 개소문합혈관적골간배천지피판수복수지피부결손적림상방법화경험.방법 2006년5월지2011년5월대29례수지피부연조직결손환자행술전채색B초정위,술중채용불휴대심근막적골간배천지피판진행수복,문합골간배동맥여지고유동맥、피하천정맥여지배정맥,병가문합골간배정맥급수지장측정맥.결과 술후27례피판존활,수방6～ 12개월,피판질지우량,외관비교만의；2례피판출현정맥위상,1례완전배사,1례부분표피배사.결론 문합혈관적골간배천지피판시일충수복수지피부결손적교호방법.
Objective To introduce the clinical experience and surgical methods of soft-tissue coverage of the finger using a free posterior interosseous dorsal perforator flap.Methods From May 2006 to May 2011,29 cases of soft tissue defects of the finger were treated.The posterior interosseous dorsal perforator was located by color Dopplar ultrasound preoperatively for flap design.The deep fascia was not included during flap harvesting.The posterior interosseous dorsal artery was anastomosed to the proper digital artery,while the subcutaneous vein in the flap was anastomosed to the dorsal vein of the finger.Alternatively the dorsal interosseous vein was anastomosed to the finger palmar subcutaneous vein.The cosmetic appearance of the donor and recipient sites were evaluated in a follow-up visit.Results Twenty-seven flaps survived uneventfully.Venous crisis occurred in 2 flaps,one of which had complete necrosis and the other had partial epidermal necrosis.After 6 to 12 months' postoperative follow-up,all patients achieved a cosmetically acceptable result.Conclusion It is a good method to repair skin defect of the finger using a free posterior interosseous dorsal perforator flap without including the deep fascia.Because of the added advantage of reducing donor-site morbidity,posterior interosseous perforator flaps have become the authors' preferred option in reconstructive cases of the finger.