评价岛状第一掌背动脉皮瓣在手背缺损重建中的多功能使用。
Evaluation of versatility of use of island first dorsal metacarpal artery flap in reconstruction of dorsal hand defects.
机构信息
Plastic Surgery Unit, General Surgery Department, Faculty of Medicine, Zagazig University, Egypt.
Plastic Surgery Unit, General Surgery Department, Faculty of Medicine, Zagazig University, Egypt.
出版信息
Asian J Surg. 2019 Jan;42(1):197-202. doi: 10.1016/j.asjsur.2018.03.004. Epub 2018 Apr 5.
BACKGROUND
Posttraumatic dorsal hand defects with exposed tendons and/or bones represent a challenge to reconstructive surgeons. Many options are suggested ranging from local, regional, distant up to free flaps. First dorsal metacarpal artery island flap was commonly prescribed for reconstructing the thumb or first web space defects.
METHODS
During a 30 month's period, 23 patients, 15 males aged between 17 and 48 years and 8 females aged between 18 and 36 years presented by posttraumatic dorsal hand defects. Of them 18 had both exposed tendons and bones while 5 had exposed tendons only. The defects dimensions ranged between 3 × 4 cm and 4.5 × 6 cm. All defects were reconstructed by using a single stage first dorsal metacarpal artery island flaps.
RESULTS
All flaps survived completely without complication during the mean follow up period of 2 years. All patients were very satisfied both functionally and aesthetically by the procedure.
CONCLUSION
Island first dorsal metacarpal artery flap is a good option for reconstructing mild to moderate dorsal hand defects with acceptable functional and cosmetic results.
背景
伴有肌腱和/或骨骼外露的创伤后手背缺陷对重建外科医生来说是一个挑战。有许多选择，包括局部、区域、远距离，甚至游离皮瓣。第一掌骨背侧动脉岛状皮瓣常用于重建拇指或第一掌间区缺陷。
方法
在 30 个月的时间里，23 名患者，15 名男性，年龄在 17 至 48 岁之间，8 名女性，年龄在 18 至 36 岁之间，因创伤后手背缺陷就诊。其中 18 例同时伴有肌腱和骨骼外露，5 例仅肌腱外露。缺损尺寸在 3×4cm 到 4.5×6cm 之间。所有缺损均采用一期第一掌骨背侧动脉岛状皮瓣重建。
结果
在平均 2 年的随访中，所有皮瓣均完全存活，无并发症。所有患者对手术的功能和美容效果都非常满意。
结论
第一掌骨背侧动脉岛状皮瓣是一种治疗轻度至中度手背缺陷的良好选择，可获得可接受的功能和美容效果。
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