Molski Marek
Klinika Chirurgii Plastycznej, Centrum Medyczne Kształcenia Podyplomowego w Warszawie.
Chir Narzadow Ruchu Ortop Pol. 2009 Sep-Oct;74(5):299-304.
Between 2002 and 2008 author treated 6 patients aged 15-40 (mean 24 years), after severe hand injuries reconstructing soft tissues of the first ray with various flaps based on perforators of distal part of radial artery. All patients requested secondary thumb reconstruction due to its amputation and disfigurement of the hand (particularly tissues of the first ray). Following three different forearm flaps based on radial artery perforators were used: adipo-cutaneous, fascio-cutaneous and island fascio-cutaneous. Primary closure of the donor site was possible in 4 cases. In remaining two patients split thickness skin grafts were used. All flaps survived. Minor partial necrosis did not impaired reconstruction of the first ray soft tissues. In two patients thumb reconstruction by the second toe transfer and rebuilt first ray soft tissues were performed in one procedure. Author suggests broader application of distal radial artery perforator flaps in soft tissues reconstruction of the first ray of the hand.
2002年至2008年间，作者治疗了6例年龄在15至40岁（平均24岁）的患者，这些患者手部严重受伤后，采用基于桡动脉远端穿支的各种皮瓣重建了第一掌骨的软组织。所有患者均因拇指截肢和手部畸形（特别是第一掌骨的组织）而要求进行二期拇指重建。采用了三种基于桡动脉穿支的不同前臂皮瓣：脂肪皮瓣、筋膜皮瓣和岛状筋膜皮瓣。4例患者供区能够一期缝合。其余2例患者采用了断层皮片移植。所有皮瓣均存活。轻微的部分坏死并未影响第一掌骨软组织的重建。2例患者在一次手术中进行了第二趾移植拇指重建并重建了第一掌骨软组织。作者建议桡动脉远端穿支皮瓣在手部第一掌骨软组织重建中更广泛地应用。
