改良指固有动脉背侧支皮瓣游离移植修复指端缺损

doi:10.13418/j.issn.1001-165x.2021.01.019

Abstract

Abstract: 目的　报道应用带指固有动脉的指固有动脉背侧支皮瓣游离移植修复指端皮肤缺损的临床效果。方法　2014年1月至2018年10月，23例23指指端皮肤软组织缺损，均伴有指骨外露，应用带指固有动脉的指固有动脉背侧支皮瓣游离移植修复。术中不用特意寻找指固有动脉背侧皮支，保留指固有动脉近节中远1/3处1cm往背侧的筋膜组织，连同指固有动脉一并切取，切除的指固有动脉予以指背静脉桥接修复，切取皮瓣面积为1.5cm×1.0cm～2.5cm×2.0cm，供区取前臂全厚皮片植皮修复。结果　23例皮瓣全部成活，术后随访3～18个月，平均10个月，皮瓣质地佳，手指外形及感觉恢复良好，两点辨别觉为 8～14mm。皮瓣供区植皮愈合良好。结论　运用改良指固有动脉背侧支皮瓣，可降低了切取难度，减少背侧支损伤可能，增加供血动脉吻合口径，降低吻合难度，是修复指端缺损一种较好的方法。

Key words: Finger injuries, 　Surgical flap, 　Microsurgery, 　Defect

CLC Number:

Wang Kai, Ju Jihui, Jin Guangzhe, Guo Liping, Li Yadong. Modified dorsal branch flap of digital artery for repair of fingertip defect[J]. Chinese Journal of Clinical Anatomy, 2021, 39(1): 101-104.

References 12

[1]	巨积辉, 金光哲, 周荣, 等. 吻合神经血管的环指指动脉背侧支皮瓣修复指腹缺损[J].中国修复重建外科杂志，2010，24(5)：559-561.
[2]	Bene MD, Petrolat M ,Raimondi P, et al. Reverse dorsal digital islang flap [J]. Plast Reconstr Surg，1994,93(3): 552-557.
[3]	李楚炎，朱小弟，李文庆，等. 指背皮支链皮瓣修复手指背侧组织缺损的临床应用[J].中国临床解剖学杂志，2019，37(2): 210-212. DOI：10.13418/j.issn.1001-165x.2019.02.019.
[4]	金光哲，巨积辉, 李雷, 等. 指动脉背侧支皮瓣的解剖学基础及临床应用[J].中国临床解剖学杂志，2012，30(4): 452-455. DOI：10.13418/j.issn.1001-165x.2012.04.032.
[5]	邓伟, 巨积辉, 李雷, 等. 血流桥接型股前外侧皮瓣修复下肢主干血管及软组织缺损创面[J]. 中国临床解剖学杂志, 2017, 35(6): 676-680. DOI：10.13418/j.issn.1001-165x.2017.06.017.
[6]	李祥军，巨积辉，刘海亮，等. 游离第二趾胫侧血流桥接皮瓣修复伴指动脉缺损的手指创面[J]. 中华手外科杂志，2017，33(5):355-357. DOI: 10.3760/cma.j.issn.1005-054X.2017.05.015.
[7]	郭礼平，巨积辉，金光哲，等. 吻合浅静脉的指背神经筋膜蒂皮瓣修复指端缺损[J]. 中华手外科杂志，2018，34（4）：254-256.DOI: 10.3760/cma.j.issn.1005-054X.2018.04.005.
[8]	唐举玉，魏在荣，张世民，等.穿支皮瓣的临床应用原则专家共识[J].中国临床解剖学杂志，2016, 34(1):4-5. DOI：10.13418/j.issn.1001-165x.2016.01.002.
[9]	刘跃飞，巨积辉，蓝波，等. 不同形式的3种胫后动脉穿支皮瓣修复足踝部创面疗效分析[J]. 中国临床解剖学杂志，2016,34（1）:28-32. DOI：10.13418/j.issn.1001-165x.2016.01.008.
[10]	蓝波，巨积辉，刘跃飞，等. 游离双股前外侧皮瓣修复全手脱套伤可行性研究[J].中国临床解剖学杂志，2015,33（3）:254-258. DOI：10.13418/j.issn.1001-165x.2015.03.004.
[11]	罗小庆, 黄忠果. 邻指指固有动脉背侧支皮支链皮瓣修复手指软组织缺损[J]. 中华显微外科杂志，2016,39（4）:398-399. DOI: 10.3760/cma.j.issn.1001-2036.2016.04.027.
[12]	吕文涛, 巨积辉, 蒋国栋, 等. 血流桥接型静脉皮瓣修复伴有指掌侧固有动脉缺损的手指创面[J].中华显微外科杂志, 2018,41(1):40-43. DOI：10.3760/cma.j.issn.1001-2036.2018.01.010

[1]	Chang Shusen, He Chunnian, Chen Wei, Zhou Jian, Zhang Fang, Nie Kaiyu, Deng Chengliang, Wei Zairong. Application of descending branch of lateral circumflex femoral artery Flow-through flap combined with MIPPO in emergency treatment of Gustilo type IIIC fracture of tibiofibula [J]. Chinese Journal of Clinical Anatomy, 2022, 40(6): 733-737.
[2]	Xue Jiajie, Wang Yaojun, Ren Zhongliang, Guo Lei. Application of the Flow-through flap of descending branch of lateral circumflex femoral artery in the limb salvage treatment of high-voltage electrical injury of the upper extremity [J]. Chinese Journal of Clinical Anatomy, 2021, 39(6): 707-710.
[3]	Kang Yongqiang, Rui Yongjun, Wu Yongwei, Ma Yunhong, Liu Jun, Gu Jun, Xu Peng, Lin Fang. Repair soft tissue defects of distal termination of leg and around the foot and ankle with perforators positioning technique assisited by color dopplerultrasound [J]. Chinese Journal of Clinical Anatomy, 2021, 39(2): 202-206.
[4]	LIU Wei, YANG Zhi, TANG Shi-ting, SHA Ke, TAN Zhen, Cheng Jian-wen, SHI Xiao-rong, ZHAO Jin-min. Peroneal perforator-plus pedicled sural neurofasciocutaneous flap for repairing lower leg and ankle soft-tissue defects [J]. Chinese Journal of Clinical Anatomy, 2020, 38(5): 593-596.
[5]	DENG Zhao-jian, JIANG Qi-jun, GAN Zheng-kai. Clinical application and effect of microsurgery through eyebrow arch for the treatment of craniopharyngioma [J]. Chinese Journal of Clinical Anatomy, 2019, 37(6): 704-707.
[6]	YAO Hai-bo, LI Wen-qing, ZHU Xiao-di, LI Chu-yan, ZHANG Guo-lei. Anatomical study of the dorsal medial arterial network of foot and its clinical significance [J]. Chinese Journal of Clinical Anatomy, 2019, 37(5): 491-493.
[7]	XIAO Rong, WANG Jian-hua, WU Yu-qiang. Repairing the finger wound with digital proper artery defect with flow-through flap based on the descending branch of supracarpal cutaneous branch of ulnar artery [J]. Chinese Journal of Clinical Anatomy, 2019, 37(4): 457-459.
[8]	ZHANG Wen-yi，GAO Feng, YI Zhi-qiang, LIU Ai-xian. Clinical application of triangular anatomy and area of cavernous sinus [J]. Chinese Journal Of Clinical Anatomy, 2019, 37(1): 1-4.
[9]	BAO Jing-jing, JIANG Lei, HUANG Xian-jun, PAN Zhi-jun. Clinical application of free descending genicular artery perforator flap for coverage of soft tissue defect of foot [J]. Chinese Journal Of Clinical Anatomy, 2018, 36(6): 694-696.
[10]	YANG Ya-dong, ZHOU Juan, TANG Wen，ZHANG Fei, LIU Yang，WEI Xiao-jun. The Saphenous neurocutaneous vascular flap in the clinical application of diabetic foot ulcers [J]. Chinese Journal Of Clinical Anatomy, 2018, 36(2): 226-230.
[11]	DENG Wei，JU Ji-hui，LI Lei，ZHOU Zheng-hu，ZHENG Bin-bing，ZHAO Dong-yang. Flow-through anterolateral thigh flap for the treatment of lower limbs wounds [J]. Chinese Journal Of Clinical Anatomy, 2017, 35(6): 676-680.
[12]	YANG Ya-dong, ZHOU Juan, TANG Wen， ZHANG Fei, WEI Xiao-jun. The medial supra-malleolus perforator flap for the clinical treatment of diabetic foot ulcers [J]. Chinese Journal Of Clinical Anatomy, 2017, 35(4): 441-444.
[13]	. Study of 3D reconstruction technique in flap design of reconstructed digits for the additional plastic surgery [J]. Chinese Journal Of Clinical Anatomy, 2015, 33(3): 301-304.
[14]	JIANG Ji-Yong, WANG Hai-Wen, GU Rong, JIANG Xin-Min, MEI Xiong-Jun. Transfer of minute wrist flap supplied by superficial palmar branch of radial artery for reconstruction of soft tissue defects of the fingers [J]. Chinese Journal Of Clinical Anatomy, 2014, 32(6): 729-731.
[15]	WANG Xu-Dong, YANG Ying-Yan, WU Wen-Jiang, HU Xiang-Yuan, WANG Wen-Gang, CHEN Wei-Lian. The clinical application of the fibula side flap of great toe [J]. Chinese Journal Of Clinical Anatomy, 2013, 31(2): 214-216.

Modified dorsal branch flap of digital artery for repair of fingertip defect

Knowledge

Abstract

Cite this article

share this article

References 12

Related Articles 15

Metrics

Comments

Recommended 0