Al-Qattan M M
Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
Ann Plast Surg. 2004 Feb;52(2):168-73. doi: 10.1097/01.sap.0000101954.16674.99.
A series of 15 cases of distally based adipofascial flaps to cover dorsal digital defects is presented. All flaps were raised just superficial to the dorsal veins (and hence preserving some fat with the reflected flaps) rather than raising them at the subdermal plane. In 3 cases where there was another injury proximal to the defect, which precluded the use of an adipofascial turnover flap from the injured digit, a distally based cross-finger adipofascial flap was used from the adjacent finger. In 4 cases, the flap was used to cover compound fractures. The results showed complete survival of all flaps without loss of the overlying skin graft and without epidermolysis of the donor skin, indicating that raising the flap just superficial to the dorsal veins does not affect the reliability of its blood supply, and yet it enhances the blood supply of the reflected skin flaps. The series also showed uneventful healing of compound fractures covered by the flap, indicating flap reliability to cover exposed fractures. Finally, the study demonstrated the feasibility of using the flap as a cross-finger flap.
本文报告了15例采用远端蒂脂肪筋膜瓣修复手指背侧缺损的病例。所有皮瓣均在指背静脉浅面掀起（因此掀起的皮瓣保留了一些脂肪），而非在皮下平面掀起。在3例缺损近端存在其他损伤，无法使用损伤手指的脂肪筋膜翻转皮瓣的病例中，采用了取自相邻手指的远端蒂交叉手指脂肪筋膜瓣。在4例病例中，皮瓣用于覆盖复合骨折。结果显示，所有皮瓣均完全存活，未出现覆盖皮片丢失及供区皮肤表皮松解，表明在指背静脉浅面掀起皮瓣不影响其血供的可靠性，且增强了掀起皮瓣的血供。该系列病例还显示，皮瓣覆盖的复合骨折愈合顺利，表明皮瓣覆盖外露骨折具有可靠性。最后，该研究证明了将该皮瓣用作交叉手指皮瓣的可行性。
