Sun Wenhai, Wang Zengtao, Qiu Shenqiang, Guan Shibing, Hu Yong, Zhu Lei, Liu Pelting
Hand and Foot Surgical Center, Provincial Hospital Affiliated to Shandong University, Jinan Shandong, 250021, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 Jan;24(1):50-2.
To investigate the operative procedure and the short-term therapeutic effects of medial plantar venous flaps for restoration of soft-tissue defects on the volar aspect of fingers.
From May 2007 to July 2009, 13 cases (15 fingers) ofvolar soft tissue defects were treated with medial plantar venous flaps, including 7 males (9 fingers) and 6 females (6 fingers) with an average age of 30 years (range, 17-55 years). Soft tissue defects were caused by electric saws in 4 cases (5 fingers), by crush injury in 6 cases (6 fingers), and by burned scar removal in 3 cases (4 fingers). The size of soft tissue defects ranged from 1.0 cm x 0.9 cm to 5.8 cm x 3.3 cm, included 5 thumbs, 3 index fingers, 3 little fingers, 2 ring fingers, and 2 middle fingers. The emergency surgical treatment was performed in 10 traumatic cases after 2 to 12 hours (4 hours on average); and the elective surgical treatment was performed in the other 3 cases of scar after burn. The 15 medial plantar venous flaps, with size of 1.0 cm x 1.0 cm to 6.0 cm x 3.5 cm, were harvested to restore defects. Of them, 12 venous flaps had 1 superficial vein and the other 3 had 2 veins; and the veins of 13 venous flaps bridged a single digital artery and the veins of the other 2 flaps bridged both arteries. The donor sites were sutured directly or were covered with skin graft.
All 15 venous flaps survived completely, and the donor and recipient sites healed by first intention. Eleven cases (11 fingers) were followed up for 2 to 12 months. The texture and color of the flaps were similar to those of adjacent normal skin with a satisfactory appearance. The two-point discrimination was 6-9 mm. According to criterion for joint junction of total active range of motion/total active range of flexion, the results were excellent in 10 cases and good in 1 case; the excellent and good rate was 100%.
The medial plantar venous flap has advantages of easy-to-operate, rich blood supply and high survival rate. So it is an ideal and reliable choice for volar soft tissue defects of fingers.
探讨足底内侧静脉皮瓣修复手指掌侧软组织缺损的手术方法及短期治疗效果。
2007年5月至2009年7月，采用足底内侧静脉皮瓣治疗13例（15指）手指掌侧软组织缺损患者，其中男7例（9指），女6例（6指），平均年龄30岁（17 - 55岁）。软组织缺损原因：电锯伤4例（5指），挤压伤6例（6指），烧伤瘢痕切除术后3例（4指）。软组织缺损面积为1.0 cm×0.9 cm至5.8 cm×3.3 cm，其中拇指5例，示指3例，小指3例，环指2例，中指2例。10例创伤患者于伤后2至12小时（平均4小时）行急诊手术治疗；另外3例烧伤后瘢痕患者行择期手术治疗。切取15块足底内侧静脉皮瓣，面积为1.0 cm×1.0 cm至6.0 cm×3.5 cm，修复缺损。其中12块皮瓣含1条浅静脉，3块含2条静脉；13块皮瓣的静脉桥接1条指动脉，2块皮瓣的静脉桥接2条动脉。供区直接缝合或植皮覆盖。
15块皮瓣全部成活，供区和受区均一期愈合。11例（11指）获2至12个月随访，皮瓣质地、颜色与相邻正常皮肤相近，外观满意。两点辨别觉为6 - 9 mm。按总主动活动范围/总主动屈曲范围关节功能评定标准，优10例，良1例，优良率为100%。
足底内侧静脉皮瓣具有操作简便、血供丰富、成活率高的优点，是修复手指掌侧软组织缺损的理想、可靠选择。
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