桡动脉腕横纹皮瓣修复手指环形组织缺损的临床观察
[Clinical observation of superficial branch of radial artery wrist crease flap for repairing ring tissue defect of fingers].
作者信息
Cheng Ding, Hu Junsheng, Cui Shuying, Zhang Jichao, Li Dongfang, Shi Rongjian, Xu Li, Shou Kuishui
机构信息
Department of Burns and Plastic Surgery, Pingdingshan Traditional Pingmei Shenma Medical Hospital, Pingdingshan Henan, 467000, P.R.China.
Department of Hand and Foot Microsurgery, Xuzhou Renci Hospital, Xuzhou Jiangsu, 221000,
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Jul 15;31(7):837-840. doi: 10.7507/1002-1892.201703096.
OBJECTIVE
To explore the effectiveness and operation method of the superficial branch of radial artery wrist crease flap for repair of ring tissue defect of the fingers.
METHODS
Between June 2013 and March 2016, the superficial branch of radial artery wrist crease flap was used to repair ring finger tissue defect in 20 cases (21 fingers). There were 14 males and 6 females with an average age of 39.3 years (range, 12-61 years). The causes included machine injury in 9 cases, traffic accident injury in 6 cases, heat inury in 2 cases, and avulsed injury in 3 cases. The index finger was involved in 6 cases, middle finger in 6 cases, ring finger in 3 cases, and little finger in 6 cases. Combined injuries included exposure of bone, tendon, vessel, and nerve. The mean time of injury to operation was 3 hours (range, 0.5-5.5 hours) in 17 patients undergoing emergency operation, and was 8.5 days (range, 7-10 days) in 3 patients undergoing selective operation. The superficial palmar branch of the radial artery from the flap was used for bridging proper digital artery. The donor site was directly sutured in 19 cases and was repaired by skin grafting in 1 case.
RESULTS
One case had blood blister at distal flap, which was cured after dressing change; the other flaps survived, and primary healing was obtained. Healing of incision at the donor site healed by first intention. The patients were followed up 6-24 months (mean, 12 months). The appearance, texture, and color of the flaps were satisfactory. The two-point discrimination ranged from 6 to 13 mm (mean, 9 mm) at 6 months after operation. According to the Chinese Medical Association Society of hand surgery of thumb and finger reconstruction function evaluation standard, the results were excellent in 13 cases, good in 4 cases, and fair in 3 cases; the excellent and good rate was 85%.
CONCLUSION
The superficial branch of radial artery wrist crease flap is an ideal choice for the repair of ring tissue defect of the fingers.
目的
探讨桡动脉腕横纹皮瓣修复手指环形组织缺损的有效性及手术方法。
方法
2013年6月至2016年3月，采用桡动脉腕横纹皮瓣修复20例（21指）手指环形组织缺损。其中男14例，女6例，平均年龄39.3岁（12～61岁）。致伤原因：机器伤9例，交通事故伤6例，热压伤2例，撕脱伤3例。累及示指6例，中指6例，环指3例，小指6例。合并伤包括骨、肌腱、血管、神经外露。17例急诊手术患者受伤至手术平均时间为3小时（0.5～5.5小时），3例择期手术患者为8.5天（7～10天）。皮瓣的桡动脉掌浅支用于桥接指固有动脉。供区19例直接缝合，1例植皮修复。
结果
1例皮瓣远端出现血疱，换药后治愈；其余皮瓣均成活，切口一期愈合。供区切口均一期愈合。患者随访6～24个月（平均12个月）。皮瓣外观、质地、色泽满意。术后6个月两点辨别觉为6～13mm（平均9mm）。按照中华医学会手外科学会拇指与手指再造功能评定标准，优13例，良4例，可3例；优良率为85%。
结论
桡动脉腕横纹皮瓣是修复手指环形组织缺损的理想选择。
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