Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Microsurgery. 2010;30(2):118-24. doi: 10.1002/micr.20718.
Treatment of composite tissue loss in the finger pulp is often difficult. The purpose of this report is to present our experience on using medial plantar artery perforator flap for repair of finger pulp defects and to restore fingertip sensation after traumatic injury.
The free medial plantar artery perforator (MPAP) flaps were performed for digital pulp reconstruction in ten patients (eight fingertips and two thumbtips) between June, 2006 and December, 2007. This flap blood supply was perforator vessel of medial plantar artery, which was through the intermuscular septum between the abductor hallucis muscle and the flexor digitorum muscle. The recipient vessels were digital artery and dorsal digital vein. The flap was not reinnervated during transfer procedures. The donor sites were closed primarily in all cases.
Flap size ranged from 15 x 25 mm to 60 x 20 mm. All flaps were survival. Partial loss occurred in one flap, due to venous congestion caused by excessive stitch tension. The donor sites healed unevenfully in eight cases, but mild wound dehiscence occurred in two cases. The follow-ups ranged from 6 to 29 months with the mean of 18.1 months. The mean of s-2PD and m-2PD were 8.8 mm and 6.8 mm at patients' last visits, respectively.
MPAP flaps are good in terms of general morbidity, cosmetic results, and durability. This flap is a valuable alternative method of repairing the glabrous finger pulp and tip defects.
手指腹复合组织缺损的治疗往往较为困难。本报告旨在介绍我们使用足底内侧动脉穿支皮瓣修复外伤性手指腹缺损和恢复指尖感觉的经验。
2006 年 6 月至 2007 年 12 月，我们对 10 例患者（8 个指尖和 2 个拇指指尖）进行了游离足底内侧动脉穿支（MPAP）皮瓣修复手指腹缺损，以恢复指尖感觉。该皮瓣的血供来源于足底内侧动脉穿支，穿过拇展肌和趾屈肌之间的肌间隔。受区血管为指动脉和指背静脉。在转移过程中，皮瓣未再神经化。所有供区均一期闭合。
皮瓣大小为 15x25mm 至 60x20mm。所有皮瓣均存活。1 例因缝线张力过大导致静脉淤血，皮瓣部分坏死。8 例供区愈合不均匀，但 2 例出现轻度伤口裂开。随访时间 6 至 29 个月，平均 18.1 个月。末次随访时，两点辨别觉（s-2PD）和平均两点辨别觉（m-2PD）分别为 8.8mm 和 6.8mm。
MPAP 皮瓣在总体发病率、美容效果和耐用性方面具有优势。该皮瓣是修复无毛发手指腹和指尖缺损的一种有价值的替代方法。
