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游离远端尺侧动脉穿支皮瓣修复手指掌侧缺损。

Free distal ulnar artery perforator flaps for the reconstruction of a volar defect in fingers.

机构信息

Department of Hand Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road No. 1277, Wuhan, Hubei Province, China.

Department of Hand Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road No. 1277, Wuhan, Hubei Province, China; Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 München, Germany.

出版信息

J Plast Reconstr Aesthet Surg. 2014 Nov;67(11):1557-63. doi: 10.1016/j.bjps.2014.05.060. Epub 2014 Jun 5.

Abstract

BACKGROUND

A volar defect in finger is a common manifestation in hand injuries, and proper volar coverage of fingers is of great significance for hand function and cosmetic appearance.

PURPOSE

The aim of our study is to investigate the feasibility of reconstructing a volar defect in fingers with the free ipsilateral distal ulnar artery perforator flap under the brachial plexus block.

METHODS

Eight free distal ulnar artery perforator flaps were used to reconstruct volar defects in eight fingers. The involved fingers were three index fingers, three long fingers, one thumb, and one ring finger. The sizes of flaps ranged from 3.0 × 4.0 to 3.0 × 11.0 cm. All the flaps were harvested from the ipsilateral forearm of the injured fingers. The donor sites were primarily closed except in one case with a skin graft. The operation time ranged from 120 to 150 min, with an average of 130 min. All the operations were performed under brachial plexus block.

RESULTS

All flaps survived completely without any complications during the 4-18 months follow-up. All the patients were satisfied with the hand function and the cosmetic appearance.

CONCLUSION

It might be a good workhorse flap to reconstruct the volar defects in fingers in hand surgery with the free distal ulnar artery perforator flaps.

摘要

背景

手指的掌侧缺损是手部损伤的常见表现,手指的掌侧覆盖对于手的功能和美观外观具有重要意义。

目的

我们的研究旨在探讨在臂丛神经阻滞下使用游离同侧尺动脉穿支皮瓣重建手指掌侧缺损的可行性。

方法

我们使用 8 个游离的尺动脉穿支皮瓣重建了 8 个手指的掌侧缺损。涉及的手指包括 3 个食指、3 个中指、1 个拇指和 1 个环指。皮瓣的大小从 3.0×4.0cm 到 3.0×11.0cm 不等。所有皮瓣均取自受伤手指同侧的前臂。除 1 例采用植皮外,供区均直接缝合。手术时间为 120-150min,平均 130min。所有手术均在臂丛神经阻滞下进行。

结果

在 4-18 个月的随访中,所有皮瓣均完全存活,无任何并发症。所有患者均对手部功能和外观感到满意。

结论

游离的尺动脉穿支皮瓣可能是手部外科重建手指掌侧缺损的一种良好的皮瓣选择。

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