Laoulakos Dimitrios H, Tsetsonis Constantinos H, Michail Aggelos A, Kaxira Olga S, Papatheodorakis Phillipos H
Plastic Surgery Department, Naval Hospital of Crete, Souda, Chania, Greece.
Plast Reconstr Surg. 2003 Jul;112(1):121-5; discussion 126-8. doi: 10.1097/01.PRS.0000066165.23202.45.
Nine patients who presented with fingertip amputations were treated with the dorsal reverse adipofascial flap. The mean age of the patients was 41.3 years and the mean follow-up was 18 months. The flap described here was used only for amputations at the level of the nail fold, from approximately the lunula to the proximal nail matrix. This flap is based on the dorsal arterial branches that originate from the volar digital arteries just distal to the distal interphalangeal joint. The flap uses only the adipofascial tissue over the middle phalanx of the injured finger; it is turned over to cover the fingertip defect and then covered with a split-thickness skin graft. All flaps survived completely, and the patients continue to use their fingertips as before the amputation injury. This one-step operation is easily performed (even in the emergency department), makes no use of the adjacent digits, and provides a pleasing and stable cover for the fingertips.
9例指尖离断患者接受了逆行背侧脂肪筋膜瓣治疗。患者平均年龄41.3岁，平均随访18个月。此处描述的皮瓣仅用于甲襞水平的离断，范围大致从半月痕至近端甲床。该皮瓣以起源于远侧指间关节远侧掌侧指动脉的背侧动脉分支为蒂。皮瓣仅使用伤指中节指骨表面的脂肪筋膜组织；将其翻转覆盖指尖缺损，然后用断层皮片覆盖。所有皮瓣均完全存活，患者指尖功能恢复至截肢伤前水平。该一步法手术操作简便（即使在急诊科也可进行），不取用相邻手指组织，为指尖提供了美观且稳定的覆盖。
