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[采用同一手指的神经血管岛状皮瓣转移修复指腹缺损]

[Transfer of neurovascular island flap from the same finger for repairing pulp defect].

作者信息

Zhou Lirong, Wang Wei, Li Jun

机构信息

Hand and Microsurgery Center, Bao Shan Branch of Shanghai No 1 Affiliated Hospital, Shanghai Jiaotong University, PR China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006 Jul;20(7):725-7.

Abstract

OBJECTIVE

To observe the clinical effects of neurovascular island flap from the same finger for repairing pulp defect.

METHODS

From November 2003 to February 2005, 32 pulp defects in 30 cases were covered with neurovascular island flap from the same finger. There were 25 males and 5 females. The age ranged from 18 to 56 years. The operation was performed after debridement and 2-8 days antibiotics therapy. The defect area ranged from 1.5 cm x 1.2 cm to 3.5 cm x 2.1 cm. The flap was harvested on the dorsal part of the finger ulnarly or radially. The distal end of the flap should be more than 5 mm away from the nail base to avoid nail injury. The ventral and dorsal cut should not exceed the middle line respectively. The flap size ranged from 2.0 cm x 1.5 cm to 4.0 cm x 2.5 cm. The donor site was covered with flap of subdermal vascular plexus from the medial side of the upper arm.

RESULTS

All 32 transferred flaps survived after operation. There was no vascular crisis. Twenty-five cases were followed up from 2 to 8 months. The flaps had good appearance and texture and blood circulation. Two-point discrimination was 7-10 mm. The function of finger motion was returned to normal.

CONCLUSION

Transfer of neurovascular island flap from the same finger offered a sensational skin flap for reconstruction of pulp defect. The technique was simple, and the clinical result was satisfactory. It is an ideal method for reconstruction of thumb or finger pulp defects.

摘要

目的

观察同指神经血管岛状皮瓣修复指腹缺损的临床效果。

方法

2003年11月至2005年2月,应用同指神经血管岛状皮瓣修复30例患者的32处指腹缺损。其中男25例,女5例;年龄18~56岁。均在清创及应用抗生素2~8天后行手术治疗。缺损面积为1.5 cm×1.2 cm至3.5 cm×2.1 cm。皮瓣于手指尺侧或桡侧背侧切取,皮瓣远端距甲根应大于5 mm以避免损伤指甲,腹侧及背侧切口分别不超过中线。皮瓣大小为2.0 cm×1.5 cm至4.0 cm×2.5 cm。供区采用上臂内侧皮下血管网皮瓣覆盖。

结果

32例移植皮瓣术后全部成活,未发生血管危象。25例获2~8个月随访,皮瓣外观、质地及血运良好,两点辨别觉为7~10 mm,手指运动功能恢复正常。

结论

同指神经血管岛状皮瓣转移是修复指腹缺损的一种感觉良好的皮瓣,技术操作简单,临床效果满意,是修复拇指或手指指腹缺损的理想方法。

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