CAJ | 학술논문

目的：探讨游离趾腓侧皮瓣与腓动脉穿支皮瓣修复手部皮肤软组织缺损的设计切取方法及临床疗效。方法2009年2月—2013年1月，对46例手部不同部位、形态的皮肤软组织缺损，分别采用游离趾腓侧皮瓣修复25例，游离腓动脉穿支皮瓣修复21例，皮肤缺损范围为1.5 cm×2.5 cm～3.0 cm×6.5 cm，根据受区皮肤软组织缺损大小、形状设计和切取皮瓣。结果本组46例皮瓣全部成活，1例出现静脉危象，经小切口放血后危象解除，皮瓣成活。术后随访6～12个月，手部整体外观、功能恢复良好，皮瓣感觉部分恢复，供区无并发症。结论应用游离趾腓侧皮瓣或腓动脉穿支皮瓣修复手部皮肤软组织缺损，可恢复手部良好的外观与功能。趾腓侧皮瓣皮肤质地、外观更接近正常手部掌侧皮肤；腓动脉穿支皮瓣可根据手部创面大小灵活切取，二者均可作为理想的游离皮瓣修复手部皮肤软组织缺损。
목적：탐토유리지비측피판여비동맥천지피판수복수부피부연조직결손적설계절취방법급림상료효。방법2009년2월—2013년1월，대46례수부불동부위、형태적피부연조직결손，분별채용유리지비측피판수복25례，유리비동맥천지피판수복21례，피부결손범위위1.5 cm×2.5 cm～3.0 cm×6.5 cm，근거수구피부연조직결손대소、형상설계화절취피판。결과본조46례피판전부성활，1례출현정맥위상，경소절구방혈후위상해제，피판성활。술후수방6～12개월，수부정체외관、공능회복량호，피판감각부분회복，공구무병발증。결론응용유리지비측피판혹비동맥천지피판수복수부피부연조직결손，가회복수부량호적외관여공능。지비측피판피부질지、외관경접근정상수부장측피부；비동맥천지피판가근거수부창면대소령활절취，이자균가작위이상적유리피판수복수부피부연조직결손。
Objective To investigate the design, harvest, and clinical efficacy of the fibular side flap of the great toe and the peroneal artery perforator flap for the restoration of soft tissue defects of the hand. Methods From February 2009 to January 2009, a series of 46 cases with hand defects were included in this study. 25 cases were repaired with the fibular side flap of the great toe, while 21 cases were reconstructed with the peroneal artery perforator flap. The range of soft tissue defect was from 1.5 cm ×2.5 cm to 3.0 cm ×6.5 cm. The flaps were designed and harvested according to the size and shape of soft tissue defect. Results All flaps survived post-operation. While 1 case was presented with veneous crisis, and the flap survived after the bloodletting procedure. All patients were followed up from 6 to 12 months postoperatively. Both the aesthetic appearance and the function of the hand were restored after operation. The sensation of the flaps were partially recovered. No donor side morbidity was presented. Conclusion In terms of the management of soft tissue defects of the hand, both the fibular side flap of the great toe and the peroneal artery perforator flap are capable of restoring the aesthetic appearance and the function of the hand. The skin condition of the fibular side flap of the great toe is similar to the normal palmar skin. The peroneal artery perforator flap can be harvested flexibility according to the size and shapes of different defects. Both of the above-mentioned flaps are ideal approaches for the reconstruction of the soft tissue defects of the hand.