Department of Plastic and Reconstructive Surgery, Central University Hospital of Asturias, Oviedo, Spain.
J Plast Reconstr Aesthet Surg. 2010 Dec;63(12):2117-22. doi: 10.1016/j.bjps.2009.11.020. Epub 2009 Dec 14.
Reverse axial adipofascial flaps use subcutaneous tissue of the laterodigital and dorsal metacarpal or digital areas. They are sited on the arterial branches anastomosing the volar and dorsal arterial networks of the fingers. These flaps allow coverage of wide and distal defects. Metacarpal flaps were used for defects on the proximal phalanx, and digital flaps for the defects over the proximal interphalangeal joint (PIPj) and further distally of the thumb and fingers. A series of 18 cases is reviewed. Dissection of the flap is easy, fast and preserves the collateral nerve and artery of the finger. Skin defects were combined with bone, joint or tendon exposure. The flaps we used were reliable, and bone, joint and tendon reconstruction could be performed at the same time. Procedures were performed in an outpatient setting. Patients were allowed to mobilise the hand as early as possible. The results showed partial distal necrosis in one case and partial loss of the overlying skin graft in two cases, who resolved spontaneously. Donor-site morbidity was minimal.
反向轴侧脂肪筋膜皮瓣利用指蹼的侧方和背侧的掌骨或指部的皮下组织。它们位于吻合手指掌侧和背侧动脉网络的动脉分支上。这些皮瓣可以覆盖广泛和远端的缺损。掌骨皮瓣用于近节指骨的缺损，而指部皮瓣用于近节指间关节（PIPj）和拇指及手指更远端的缺损。回顾了一系列 18 例病例。皮瓣的解剖简单、快速，并保留了手指的侧支神经和动脉。皮肤缺损与骨、关节或肌腱外露相结合。我们使用的皮瓣是可靠的，并且可以同时进行骨、关节和肌腱重建。手术在门诊进行。患者可以尽早开始手部活动。结果显示一例出现部分远端坏死，两例出现覆盖的皮片移植部分丢失，但均自发缓解。供区并发症很少。
