改良骨间背动脉逆行岛状皮瓣修复手部背侧皮肤软组织缺损的疗效观察

[Effectiveness of improved interosseous dorsal artery reversed island flap for dorsal skin and soft tissue defect of hand].

作者信息

Bu Fanyu, Xue Mingyu, Rui Yongjun, Gu Liming, Shou Kuishui, Qiang Li, Zhou Xiao

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014 Feb;28(2):237-40.

Abstract

OBJECTIVE

To discuss the effectiveness of improved interosseous dorsal artery reversed island flap to repair dorsal skin and soft tissue defect of the hand.

METHODS

Between March 2009 and September 2012, 29 cases of dorsal skin and soft tissue defects were treated with improved interosseous dorsal artery reversed island flap. Of 29 cases, there were 17 males and 12 females, aged 23-71 years (mean, 47 years); and the left hand was involved in 12 cases and the right hand in 17 cases. There were 11 cases of avulsion injury, 9 cases of crushing injury, 5 cases of strangulation injury, and 2 cases of traffic accident injury; the interval of injury and admission was 1-7 hours (mean, 4 hours). Two patients had scar contracture. The locations of soft tissue defects were dorsal hands in 21 cases, first webs in 5 cases, and dorsal thumb in 3 cases. The size of soft tissue defects ranged from 4 cm x 3 cm to 10 cm x 8 cm. One-stage repair was performed in 11 cases, and two-stage repair in 18 cases. The size of flaps ranged from 5.5 cm x 4.5 cm to 12.0 cm x 10.0 cm. The donor sites were sutured directly or repaired by skin grafting.

RESULTS

All flaps survived, and wounds healed in first stage. And the grafted skins at donor sites all survived, and incisions all healed in first stage. Twenty-six patients were followed up 3 months-3 years (mean, 19.5 months). Bulky flap was observed in 3 cases, and defatted operation was performed after 6 months; the other flaps had good appearance and texture, and wrist function was normal. According to total angle of motion (TAM) systematic evaluation, the results were excellent in 17 cases, good in 6 cases, and fair in 3 cases at 3 months after operation.

CONCLUSION

Improved interosseous dorsal artery reversed island flap has the advantages of easy-to-obtain, simple operation, and high survival rate of flaps, so it is an effective method to repair dorsal skin and soft tissue defect of the hand.

摘要

目的

探讨改良骨间背动脉逆行岛状皮瓣修复手部背侧皮肤软组织缺损的疗效。

方法

2009年3月至2012年9月，采用改良骨间背动脉逆行岛状皮瓣治疗29例手部背侧皮肤软组织缺损患者。其中男17例，女12例，年龄23 - 71岁（平均47岁）；左手12例，右手17例。撕脱伤11例，挤压伤9例，绞窄伤5例，交通事故伤2例；受伤至入院时间1 - 7小时（平均4小时）。2例有瘢痕挛缩。软组织缺损部位：手背21例，虎口5例，拇指背侧3例。软组织缺损面积4 cm×3 cm至10 cm×8 cm。11例行一期修复，18例行二期修复。皮瓣面积5.5 cm×4.5 cm至12.0 cm×10.0 cm。供区直接缝合或植皮修复。