CAJ | 학술논문

目的探讨以指动脉皮穿支蒂接力皮瓣修复指端皮肤软组织缺损的方法及疗效.方法 2012年3月至2014年6月,对9例指端皮肤软组织缺损的病例,采用指侧方指动脉皮支链皮瓣修复,皮瓣大小为1.3 cm×1.6 cm～1.6 cm×2.2 cm.同时,设计近创面指动脉指蹼穿支蒂V-Y推进皮瓣接力修复供区.结果术后9例18块皮瓣完全成活,创面一期愈合,供区切口一期愈合.术后随访5个月至2年,平均12个月,皮瓣外观及弹性好,伤指无疼痛;指端皮瓣静止两点辨距觉为7～8 mm,指蹼穿支皮瓣静止两点辨距觉为10～ 12 mm.手功能按ATM法评定:优7例,良2例.冬季患指无皮温低和怕冷等现象,皮瓣供区指蹼大小和深度无影响,无瘢痕挛缩,指蹼最大外展达30°～ 40°.结论采用指动脉皮支蒂接力皮瓣修复指端皮肤软组织缺损,操作简单,术后疗效满意,不牺牲主干血管,供区可直接缝合,并避免了移植皮片的弊端.
목적 탐토이지동맥피천지체접력피판수복지단피부연조직결손적방법급료효.방법 2012년3월지2014년6월,대9례지단피부연조직결손적병례,채용지측방지동맥피지련피판수복,피판대소위1.3 cm×1.6 cm～1.6 cm×2.2 cm.동시,설계근창면지동맥지복천지체V-Y추진피판접력수복공구.결과 술후9례18괴피판완전성활,창면일기유합,공구절구일기유합.술후수방5개월지2년,평균12개월,피판외관급탄성호,상지무동통;지단피판정지량점변거각위7～8 mm,지복천지피판정지량점변거각위10～ 12 mm.수공능안ATM법평정:우7례,량2례.동계환지무피온저화파랭등현상,피판공구지복대소화심도무영향,무반흔련축,지복최대외전체30°～ 40°.결론 채용지동맥피지체접력피판수복지단피부연조직결손,조작간단,술후료효만의,불희생주간혈관,공구가직접봉합,병피면료이식피편적폐단.
Objective To investigate the application of relay flaps pedicled by perforator from digital artery for reconstruction of soft tissue defects at finger tip.Methods From Mar.2012 to Jun.2014, 9 cases with soft tissue defects at finger tip were reconstructed with relay flaps at one side of finger pedicled by perforator from digital artery.The flap size ranged from 1.3 cm × 1.6 cm to 1.6 cm × 2.2 cm.The defects at donor sites were covered by adjacent web perforator V-Y advanced flaps.Results All the 18 flaps in 9 cases survived completely with primary healing both in recipient and donor sites.The patients were followed up for 5 months to 2 years (average, 12 months) with good elasticity and cosmetic results.No pain happened in the treated finger.The 2-point discrimination distance was 7-8 mm in fingertip flaps, and 10-12 mm in web perforator flaps.Hand function was graded as excellent in 7 cases, good in 2 cases, based on ATM assessment.The affected fingers had normal temperature and cold-resistance during winter.The width and depth of web in the donor site were not affected.Conclusions The relay flaps pedicled by perforator from digital artery can be applied for reconstruction of soft tissue defects at finger tip.The procedure is easy with satisfactory results and reservation of main artery.No skin graft is necessary for closure of defects on donor sites.