掌背动脉逆行岛状皮瓣修复多指皮肤缺损.doc

掌背动脉逆行岛状皮瓣修复多指皮肤缺损.doc掌背动脉逆行岛状皮瓣修复多指皮肤缺损
【摘要】目的探索应用掌背动脉逆行岛状皮瓣修复多手指软组织缺损的方法。方法应用掌背动脉逆行岛状皮瓣修复手指软组织缺损21例46指。结果术后21例46块皮瓣全部存活。随访时间为3~14个月,皮瓣外形优良,不臃肿,皮瓣两点分辨觉为4~9 mm。供区植皮成活,掌背有环形瘢痕,少许色素沉着。结论掌背动脉逆行岛状皮瓣操作方便,易切取,损伤小,不牺牲主干动脉,手术可同时切取多块皮瓣修复多指软组织缺损,是修复多手指皮肤软组织缺损的良好方法。
【关键词】外科皮瓣;指损伤;组织缺损
Dorsal metacarpal artery reverse island flap to repair skin defect of fingers
[Abstract] Objective To report the method and treatment oute of repairing soft tissue loss of many fingers etacarpal artery reverse island 21 cases of soft tissue loss in 46 fingers etacarpal artery reverse island All 46 flaps of 21 patients survived. The patients onths to 14 appearance of the flaps 4 to 9 graft at the donor site survived of the pigmentation etacarpal artery reverse island flap is an optimal method for coverage of soft tissue defect of the surgery is easy and less major artery needs to be other advantage is that multiple flaps can be harvested at the same time for coverage of defects of more than one finger.
[Key × cm~3 cm× cm。
手术方法
cm处[1],该点为掌背动脉吻合支注入指掌侧总动脉的位置。皮瓣的轴心线为经指蹼中点与相应掌骨的平行线。皮瓣解剖面在深筋膜与伸肌腱腱周组织之间。掌背动静脉蒂在骨间背侧肌肌膜的深面分离,切取范围近端达腕背横纹,远端至指蹼边缘,~ cm。
手术步骤臂丛神经阻滞麻醉下,上肢不驱血,上臂上止血带。彻底清创后按各指缺损面积及形状制成多个纸样片,将各纸样片置于掌背拼连在一起。修复示、中、环、小指的皮瓣分别切取第Ⅰ、Ⅱ、Ⅲ、Ⅳ掌背动脉皮瓣,如三指或少于三指修复时,可切取第Ⅱ掌背动