CAJ | 학술논문

目的：介绍一种对手指供区损伤较小的皮瓣修复手指指端缺损的方法。方法对15例手指指端缺损患者，以指固有动脉中段及其背侧支为蒂，设计手指中节指背岛状皮瓣进行修复。若需重建皮瓣感觉，则在切取皮瓣时，于皮瓣近端切取适当长度的指固有神经背侧支，与伤指指固有神经缝合。结果15指皮瓣及植皮全部成活，5指术后2 d皮瓣远端出现水疱，未予处理，术后7 d水疱开始萎缩吸收，术后2周水疱消失。术后随访3~9个月，皮瓣成活好，质地柔软，外形满意，颜色与患指周围皮肤相近，两点辨别觉6~9 mm，远指间关节屈伸功能无明显障碍。手功能根据ATM法评定：优10例，良5例。结论中节指动脉及其背侧支为蒂逆行岛状皮瓣是修复指端缺损较理想的方法之一。
목적：개소일충대수지공구손상교소적피판수복수지지단결손적방법。방법대15례수지지단결손환자，이지고유동맥중단급기배측지위체，설계수지중절지배도상피판진행수복。약수중건피판감각，칙재절취피판시，우피판근단절취괄당장도적지고유신경배측지，여상지지고유신경봉합。결과15지피판급식피전부성활，5지술후2 d피판원단출현수포，미여처리，술후7 d수포개시위축흡수，술후2주수포소실。술후수방3~9개월，피판성활호，질지유연，외형만의，안색여환지주위피부상근，량점변별각6~9 mm，원지간관절굴신공능무명현장애。수공능근거ATM법평정：우10례，량5례。결론중절지동맥급기배측지위체역행도상피판시수복지단결손교이상적방법지일。
Objective To introduce a flap which injured slightly on the donor sites, in repairing the fingertip defect. Methods 15 cases with defect on 15 fingers tip were treated with this island flaps. When the flap was used to repair defect at finger pulp, the dorsal branch of the digital proper nerve in the flap was kept to be anastomosed to the digital proper nerve at the recipient finger. Results All the flaps and skin grafts survived. Blister happened in 5 flaps 2 days after operation, which healed spontaneously without necrosis. The blister begin to shrink and be obsorption 7 days after operation, and disappear 2 weeks after operation. All cases were followed up for 3~9 months. The color, texture and contour of the flaps were good. The two-point discrimination distance was 6~9 mm on the flaps. No obvious functional problem was found in DIP motion. The hand function was assessed as excellent in 10 fingers, good in 5 fingers. Conclusion The reverse island flap based on middle phalange of digital artery and its dorsal branches is an ideal method to repair the fingertip defect.