Yang Shuaizhi, Chen Lu, Zheng Canbin, Yang Jungui, Huang Yu, Cui Jiande
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Apr;30(4):440-3.
To investigate the application of the double skin paddle arterialized venous flaps for reconstruction of soft tissue defects in the middle and proximal parts of double fingers.
Between September 2011 and December 2014, 6 cases (12 fingers) of soft tissue defects in the middle and proximal parts of double fingers underwent reconstructive surgery with the double skin paddle arterialized venous flaps. There were 5 males and 1 female with an average age of 33.8 years (range, 19-52 years). The causes included cut injury in 4 cases and crush injury in 2 cases. Five index fingers, 3 middle fingers, 2 ring fingers, and 2 little fingers were involved. All defects located at proximal and middle fingers and defect did not exceed the distal interphalangeal joint. The defect area ranged from 2.5 cm x 2.5 cm to 5.5 cmx4.0 cm. All cases had bone or tendon exposure, and 2 cases had phalangeal fracture. The disease duration was 1.5-7 hours (mean, 3.5 hours). The flap size was 8 cm x 3 cm-14 cm x 5 cm. The donor site was directly sutured (≤ 3.0 cm in width) or was repaired with skin graft (> 3.0 cm in width).
The operation time was 2.5-5.0 hours (mean, 4.0 hours). All flaps survived completely. Tensive blisters occurred in 4 cases and were improved at 1 week after removal of suture around pedicle. Partial distal flap necrosis was noted in 1 case, healing was obtained after secondary debridement; other wounds healed in one stage. The patients were followed up 6-18 months (mean, 13 months). The flap had good texture, elasticity, and appearance. According to the hand function evaluation criteria issued by the Chinese Hand Society, the results were excellent in 3 cases, good in 2 cases, and fair in 1 case at last follow-up. The two-point discrimination of the flap was 8-10 mm (mean, 9 mm).
The double skin paddle arterialized venous flaps have the advantages of simple technique and definite effectiveness for reconstruction of soft tissue defects in the middle and proximal part of double fingers.
探讨双叶动脉化静脉皮瓣在双手指中、近节软组织缺损修复中的应用。
2011年9月至2014年12月，对6例（12指）双手指中、近节软组织缺损患者采用双叶动脉化静脉皮瓣进行修复重建手术。男5例，女1例，平均年龄33.8岁（19 - 52岁）。致伤原因：切割伤4例，挤压伤2例。涉及示指5指、中指3指、环指2指、小指2指。所有缺损均位于手指中、近节，未超过远侧指间关节。缺损面积为2.5 cm×2.5 cm至5.5 cm×4.0 cm。所有病例均有骨或肌腱外露，2例合并指骨骨折。伤后至手术时间为1.5 - 7小时（平均3.5小时）。皮瓣大小为8 cm×3 cm至14 cm×5 cm。供区创面宽度≤3.0 cm者直接缝合，>3.0 cm者采用植皮修复。
手术时间为2.5 - 5.0小时（平均4.0小时）。所有皮瓣全部成活。4例出现张力性水疱，于蒂部拆线后1周好转。1例皮瓣远端部分坏死，经二次清创后愈合；其余创面均一期愈合。患者随访6 - 18个月（平均13个月）。皮瓣质地、弹性及外观良好。末次随访时，按中华医学会手外科学分会手功能评定标准，优3例，良2例，可1例。皮瓣两点辨别觉为8 - 10 mm（平均9 mm）。
双叶动脉化静脉皮瓣修复双手指中、近节软组织缺损技术操作简单，效果确切。
