【摘要】：目的探討橈動脈穿支腕橫紋皮瓣橋接修復(fù)手指環(huán)形缺損的療效。方法 2013年6月—2016年3月,采用橈動脈穿支腕橫紋皮瓣橋接修復(fù)20例(21指)手指環(huán)形缺損。其中男14例,女6例;年齡12~61歲,平均39.3歲。致傷原因:機器絞壓傷9例,交通事故傷6例,熱壓傷2例,撕脫傷3例。受傷指別:示指6例,中指6例,環(huán)指3例,小指6例。缺損合并骨、肌腱、血管、神經(jīng)外露。其中急診手術(shù)17例,受傷至手術(shù)時間0.5~5.5 h,平均3 h;擇期手術(shù)3例,受傷至手術(shù)時間7~10 d,平均8.5 d。利用該皮瓣中的橈動脈掌淺支橋接修復(fù)指固有動脈,恢復(fù)手指血運;19例供區(qū)可直接縫合,1例植皮修復(fù)。結(jié)果術(shù)后1例皮瓣遠端部分皮膚血皰形成,經(jīng)換藥后愈合;余皮瓣均成活,創(chuàng)面Ⅰ期愈合。供區(qū)切口及創(chuàng)面均Ⅰ期愈合,外觀良好、瘢痕小。20例均獲隨訪,隨訪時間6~24個月,平均12個月。術(shù)后手指外觀恢復(fù)良好,皮瓣質(zhì)地、外形滿意。術(shù)后6個月皮瓣兩點辨別覺為6~13 mm,平均9 mm;患指功能按中華醫(yī)學(xué)會手外科學(xué)會上肢部分功能評定試用標準評定:優(yōu)13例,良4例,可3例,優(yōu)良率85%。結(jié)論橈動脈穿支腕橫紋皮瓣是修復(fù)手指環(huán)形缺損較理想的方式。
[Abstract]:Objective to investigate the effect of radial artery perforating carpal transverse flap for repairing finger ring defect. Methods from June 2013 to March 2016, 20 cases (21 fingers) of finger ring defect were repaired with radial artery perforator wrist transverse flap. Among them, 14 cases were males and 6 cases were females, the age was 1261 years (mean 39.3 years). The causes of the injury were: mechanical strangulation injury in 9 cases, traffic accident in 6 cases, hot pressure injury in 2 cases and avulsion injury in 3 cases. There were 6 cases of finger injury, 6 cases of middle finger, 3 cases of ring finger and 6 cases of small finger. Defects associated with bone, tendon, blood vessels, and nerve exposure. 17 cases were operated in emergency department, the time from injury to operation was 0.5 ~ 5.5 h (mean 3 h), and 3 cases from elective operation to 7 ~ 10 d (average 8.5 d). The superficial palmar branch of the radial artery was used to repair the digital artery to restore the blood flow of the finger, 19 cases could be sutured directly, and 1 case was repaired with skin graft. Results Blood blister of the distal part of the flap was formed in one case, and healed after dressing change. All the remaining flaps survived and the wound healed in the first stage. The donor incision and wound healed in the first stage with good appearance and small scar. 20 cases were followed up for 624 months with an average of 12 months. After operation, the appearance of the fingers recovered well, the skin flap texture and appearance were satisfactory. Six months after operation, the two-point discriminant perception of the flap was 6 ~ 13 mm, and the average affected finger function was 9 mm; according to the evaluation criteria of the upper limb function of the Chinese Medical Association: excellent 13 cases, good 4 cases, fair 3 cases, excellent and good rate 85%. Conclusion Radial artery perforating carpal transverse flap is an ideal method for repairing finger ring defect.
【作者單位】： 平頂山市平煤神馬醫(yī)療集團總醫(yī)院燒傷整形科;徐州仁慈醫(yī)院手足顯微外科;
【分類號】：R658.2

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