Ozdemir R, Kilinç H, Sensöz O, Unlü R E, Baran C N
Department of Plastic and Reconstructive Surgery, Ankara Numune Hospital, Ankara, Turkey.
Ann Plast Surg. 2001 Jan;46(1):9-14. doi: 10.1097/00000637-200101000-00003.
Traumatic or thermal injury to the fingertip may result in composite tissue loss. Exposed tendon, bone, or joint surface is best treated by flap coverage. The authors present their experience with a new technique that provides coverage for fingertip defects using the innervated dorsal adipofascial turnover flap, which consists of adipofascial tissue only and relies on the arterial anastomotic network of this tissue layer to sustain its vascularization. Eight digital amputations between the distal phalanx proximal to the nail matrix and midportion of the middle phalanx were resurfaced successfully with the innervated dorsal adipofascial turnover flap. The flaps survived completely; the mean follow-up was 9 months. This technique seems to be a relatively simple way of achieving early recovery. It does not require the use of distant flap immobilization of adjacent digits, nor does it require the use of homodigital flaps, which may jeopardize an already injured finger. The main advantages of the innervated dorsal adipofascial turnover flap are its ready availability from the local tissue, its sensation, and the absence of functional and aesthetic disturbance at the donor site.
指尖的创伤或热损伤可能导致复合组织缺失。暴露的肌腱、骨骼或关节面最好通过皮瓣覆盖进行治疗。作者介绍了他们使用带神经支配的背侧脂肪筋膜翻转皮瓣覆盖指尖缺损的新技术经验，该皮瓣仅由脂肪筋膜组织构成，依靠该组织层的动脉吻合网络维持其血运。8例在甲床近端的远节指骨与中节指骨中部之间的手指离断伤，成功地用带神经支配的背侧脂肪筋膜翻转皮瓣进行了创面修复。皮瓣完全存活；平均随访9个月。该技术似乎是实现早期恢复的一种相对简单的方法。它不需要使用远处皮瓣或固定相邻手指，也不需要使用可能危及本已受伤手指的同指皮瓣。带神经支配的背侧脂肪筋膜翻转皮瓣的主要优点是可从局部组织轻易获取、具有感觉功能，且供区无功能和美观方面的干扰。
