摘要
目的探讨吻合浅静脉的指背神经筋膜蒂皮瓣修复指端缺损的临床疗效。方法自2016年1月至2017年2月，我们对25例25指指端缺损患者采用近节指背神经筋膜蒂皮瓣修复创面，术中保留皮瓣近端的一条浅静脉断端，皮瓣转移至创面后将该浅静脉断端与指端皮下静脉断端吻合，重建皮瓣静脉循环。结果本组25例25指皮瓣均存活，术后2周内皮瓣外观良好，无水泡及皮色青紫。术后随访时间为6—8个月，平均6．5个月，皮瓣外观良好，无明显臃肿，质地柔软，部分皮瓣色素沉着，皮瓣痛温觉均恢复，手指各关节活动良好。所有指背植皮成活。结论吻合浅静脉的指背神经筋膜蒂皮瓣修复指端缺损克服了传统的指背神经筋膜蒂皮瓣回流不佳的缺点，皮瓣存活得到有效保证。
Objective To investigate the clinical efficacy of dorsal digital nerves fasciocutaneous flap with superficial vein anastomosis in the treatment of fingertip defects, Methods From January 2016 to February 2017, 25 cases （25 fingers） of fingertip defects were treated with proximal dorsal digital nerve fasciocutaneous flap. After the flap was transferred to cover the wound, the stump of a superficial vein retained at the proximal end of the flap was anastomosed to the stump of fingertip subcutaneous vein for reconstruction of flap venous circulation. Results All the flaps survived uneventfully. The appearance of flaps was good without blisters and purple skin 2 weeks after operation. The postoperative follow-up time ranged from 6 to 8 months with an average of 6.5 months. The flap had good appearance, no obvious bulky shape and soft texture. Some flaps had pigmentation. The skin pain and temperature sensation were restored. The joints of the fingers were in good motion. All the skin grafts survived. Conclusion The dorsal digital nerve fasciocutaneous flap with superficial vein anastomosis for repair of fingertip defects overcomes the shortcomings of the traditional flap with poor backflow, and the survival of the flap is effectively guaranteed.
作者
郭礼平
巨积辉
金光哲
王凯
郭全伟
Guo Liping;Ju Jihui;Jin Guangzhe;Wang Kai;Guo Quanwei(Department of Hand Surgery,Ruihua Hospital Affiliated to Suzhou University,Jiangsu 215000,China)
出处
《中华手外科杂志》
CSCD
北大核心
2018年第4期254-256,共3页
Chinese Journal of Hand Surgery
基金
江苏省自然科学基金项目（BK20151203）
江苏省青年医学人才项目（QNRC2016224）
关键词
外科皮瓣
治疗结果
指端缺损
筋膜蒂
浅静脉吻合
Surgical flaps
Treatment outcome
Fingertip defects
Fascial pedicle
Superficial vein anastomosis
