论文部分内容阅读
目的 探讨应用指动脉微型穿支螺旋桨皮瓣修复手指皮肤软组织缺损的方法和临床疗效.方法 自2013年12月至2014年12月,对18例手指皮肤软组织缺损患者,应用指动脉微型穿支螺旋桨皮瓣进行修复,其中拇指8例、示指5例、中指3例、环指2例.皮肤缺损面积1.5 cm×0.9 cm～ 3.5 cm× 2.0 cm,均伴有肌腱或指骨外露,皮瓣切取面积2.5 cm× 1.1 cm～5.0 cm×2.5 cm.术后供区直接缝合8例,游离植皮10例.结果15例皮瓣顺利存活,3例皮瓣术后出现静脉危象,经拆线、换药后存活.术后16例获得随访(2例失访),时间3～12个月,平均8个月,皮瓣蒂部平整,外形满意,质地柔软,按中华医学会手外科学会上肢部分功能评定试用标准评定:优8例,良6例,可2例.结论应用指动脉微型穿支螺旋桨皮瓣修复手指皮肤软组织缺损,操作相对简单,供区损伤小,皮瓣外形满意,功能恢复良好,是一种较理想的手术方式.“,”Objective To discuss the surgical technique and clinical outcomes of digital artery perforator mini propeller flap for soft tissue coverage of finger defects.Methods Soft tissue defects of the fingers in 18 patients were repaired with digital artery perforator mini propeller flap from December 2013 to December 2014.The defects involved the thumb in 8 cases,the index finger in 5 cases,the middle finger in 3 cases,and the ring finger in 2 cases.The size of the defect ranged from 1.5 cm × 0.9 cm to 3.5 cm× 2.0 cm.Tendon or bone exposure existed in all the cases.The flap size ranged from 2.5 cm × 1.1 cm to 5.0 cm × 2.5 cm.The donor sites could be closed directly in 8 cases while skin graft was required in 10 cases.Results Flaps in 15 cases survived uneventfully,while those in 3 cases had venous crisis which was resolved by removing some of the stitches.All but 2 patients had 3 to 12 months postoperative follow-up,with an average of 8 months.The flaps had satisfactory appearance and pliable texture.According to the upper limb functional assessment criteria formulated by the Hand Surgery Society of the Chinese Medical Association,the results were excellent in 8 cases,good in 6 cases,and fair in 2 cases.Conclusion Digital artery perforator mini propeller flap is a good option for soft tissue coverage of finger defects.The procedure is relatively simple with less damage to the donor site.Aesthetic and functional outcomes are satisfactory.