摘要
目的:手指外伤后或瘢痕切除后造成皮肤软组织缺损,修复的方法多种多样,但由于手部对功能要求较高,所以许多方法并不尽如人意。近年来,随着对掌背动脉解剖研究的深入,掌背动脉逆行岛状皮瓣得到越来越广泛的应用。资料来源:应用计算机检索Pubmed1990-01/2006-01与掌背动脉逆行皮瓣相关的文章,英文检索词为“dorsalmetacarpalartery,surgicalflap,islandflap”,语种为英文;同期检索中文期刊全文数据库、万方数据库的相关文章,检索词为“掌背动脉,外科皮瓣,岛状皮瓣”,语种为中文。资料选择:对资料进行初审,选取与掌背动脉逆行岛状皮瓣相关的文献,对掌背动脉顺行岛状皮瓣的文献及重复性研究的文献不采纳。资料提炼:共收集到63篇相关文献,排除20篇掌背动脉顺行岛状皮瓣的文献,排除22篇重复性研究的文献,实际纳入21篇。资料综合:手背皮肤是修复手指软组织缺损的良好供区,在手背走行4条掌背动脉,其末端吻合支将掌背动脉与指掌侧总动脉相连,根据这一解剖基础,可以设计以掌背动脉为轴心血管的掌背逆行岛状皮瓣修复手部软组织的缺损。其轴心线为掌背动脉,旋转点为掌背动脉末端向指掌侧动脉发出交通支的部位,切取范围:皮瓣上界为腕背横纹,下界为指蹼边缘,宽可达血管轴心线两侧各25mm。结论:掌背逆行岛状皮瓣修复手部软组织的缺损,该手术简单实用,不损伤大的血管和神经,是一种安全、微创的方法。
OBJECTIVE： Although there are many methods for repairing defects of skin and soft tissue caused by injury of hand or removal of scar, with the high requirement for hands, many of them are not satisfied. In recent years, with the development of studying for dorsal metacarpal artery, reverse dorsal metacarpal island flap is more and more widely applied.
DATA SOURCES： A computer-based online search of Pubmed was undertaken for articles about reverse dorsal metacarpal island flap published in English between January 1990 and January 2006 with the key words of ＂dorsal metacarpal artery, surgical flap, island flap＂. Meanwhile, we searched CNKI and wanfang database for related articles with the same key words in Chinese.
STUDY SELECTION： After primary examination, the literatures related to reverse dorsal metacarpal artery island flap were selected, those related to sequential dorsal metacarpal artery island flap and the repetitive researches were excluded.
DATA EXTRACTION： Totally 63 relevant literatures were collected, after excluded 20 literatures related to sequential dorsal metacarpal artery island flap and 22 repetitive ones, 21 articles were included.
DATA SYNTHESIS： Dorsum of hand is an ideal skin-flap donor site for coverage of hand or finger defects. There are four dorsal metacarpal arteries among each metacarpal, which make distal intermetacarpal anastomosis between dorsal and palmar vascular networks by an anastomosis branch. A reverse dorsal island flap is designed to repair the defects of soft tissues of hand by using the dorsal metacarpal artery as the axis vessel, the part stretch out communicating branch from the end of dorsal metacarpal artery to side artery of hand as the rotating point. The flap can be cut from dorsal wrist transverse line to digital web, 25 mm from the vessel axis.
CONCLUSION： Reverse dorsal metacarpal artery island flap for repairing digital skin defects is easily to do and practical. It is a simple, safe and minimally invasive method without injures of important blood vessel and nerve in hand.
出处
《中国临床康复》
CSCD
北大核心
2006年第44期106-108,共3页
Chinese Journal of Clinical Rehabilitation
