Huang Liangku, Xu Yuben, Li Peng, Xia Lei, Tian Zhao, Lu Meng, Xu Tao
The Second Department of Hand Surgery, Red Cross Hospital Affiliated to Medical School of Xi'an Jiao Tong University, Xi'an Shaanxi, 710054, P.R.China.
Department of Anesthesia, Red Cross Hospital Affiliated to Medical School of Xi'an Jiao Tong University, Xi'an Shaanxi, 710054,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Jul 15;32(7):955-958. doi: 10.7507/1002-1892.201801040.
To evaluate the surgical technique and the effectiveness of the free superficial palmar branch of the radial artery flap to repair soft tissue defect of fingers.
Between June 2014 and June 2017, 10 cases (10 fingers) of soft tissue defects of fingers were repaired with the free superficial palmar branch of the radial artery flaps. There were 8 males and 2 females with an average age of 29.8 years (range, 23-42 years). The causes of injury included the chainsaw cutting injury in 6 cases, the machine crush injury in 2 cases, and the glass scratching in 2 cases. The time from injury to admission was 1-8 hours with an average of 3 hours. The locations were the volar of the middle of index finger in 3 cases, the volar of the distal of index finger in 1 case, the volar of the distal of middle finger in 3 cases, the ulnar side of distal interphalangeal joint of ring finger in 1 case, and the volar of the distal of the little finger in 2 cases. The area of soft tissue defect ranged from 1.8 cm×0.9 cm to 2.8 cm×2.1 cm, and the area of flap ranged from 2.0 cm×1.0 cm to 3.0 cm×2.3 cm. The donor sites were sutured directly.
All flaps survived after operation, and the wounds healed by first intention. The incisions of donor site also healed by first intention with a linear scar. All cases were followed up 6-12 months (mean, 9 months). The appearance and texture of the flaps were satisfactory. The pain sensation, warm sensation, and touch sensation of the flap recovered. At last follow-up, the two-point discrimination of the flap was 6-13 mm (mean, 7.5 mm). According to the assessment of the upper limb function issued by tha Hand Surgery Society of Chinese Medical Association, the results were graded as excellent in 8 cases and good in 2 cases.
The free superficial palmar branch of the radial artery flap is easy to harvest and anastomose and has small injury. It is an ideal method in repairing of soft tissue defects of fingers.
评估桡动脉掌浅支游离皮瓣修复手指软组织缺损的手术技术及疗效。
2014年6月至2017年6月，采用桡动脉掌浅支游离皮瓣修复10例（10指）手指软组织缺损。男8例，女2例，平均年龄29.8岁（23 - 42岁）。损伤原因包括电锯切割伤6例，机器挤压伤2例，玻璃划伤2例。伤后至入院时间为1 - 8小时，平均3小时。部位：示指中节掌侧3例，示指末节掌侧1例，中指末节掌侧3例，环指远侧指间关节尺侧1例，小指末节掌侧2例。软组织缺损面积为1.8 cm×0.9 cm至2.8 cm×2.1 cm，皮瓣面积为2.0 cm×1.0 cm至3.0 cm×2.3 cm。供区直接缝合。
术后皮瓣全部成活，创面一期愈合。供区切口亦一期愈合，遗留线状瘢痕。所有病例随访6 - 12个月（平均9个月）。皮瓣外观及质地满意，皮瓣痛觉、温觉及触觉恢复。末次随访时，皮瓣两点辨别觉为6 - 13 mm（平均7.5 mm）。参照中华医学会手外科学分会上肢功能评定标准，结果为优8例，良2例。
桡动脉掌浅支游离皮瓣切取及吻合容易，损伤小，是修复手指软组织缺损的理想方法。
