Zhao Min, Wu Jinying, Yuan Zuoxiong, Tian Dehu, Shao Xinzhong, Li Dacun, Li Jianfeng, Liu Jingda, Zhao Liang, Li Hailei, Wang Xiaolei
Department of Upper Limb Surgery, Beijing Shunyi Hospital, Beijing, 101300, P.R.China.
Department of Anatomy, Capital Medical University Yanjing Medical College, Beijing, 101300, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 May 15;33(5):586-589. doi: 10.7507/1002-1892.201901057.
To investigate the effectiveness of radial-lateral forearm free perforator flap on repairing of soft tissue defects in the finger.
Between January 2017 and May 2018, 26 cases of finger skin defects were treated with radial-lateral forearm free perforator flap based on the radial branch of the posterior interosseus artery. There were 21 males and 5 females, with an average age of 26.6 years (range, 19-56 years). The cause of injury included the cutting injury in 16 cases and crush injury in 10 cases. The interval between injury and admission was 30 minutes to 4 hours (mean, 1.5 hours). The injury located at thumb in 6 cases, index finger in 8 cases, middle finger in 6 cases, ring finger in 3 cases, and little finger in 3 cases; and at the dorsum of finger in 6 cases, the lateral side in 6 cases, and the palm in 14 cases. All wounds were accompanied with the tendon and bone exposures, and phalangeal fractures occurred in 10 cases. The size of the defects ranged from 2.0 cm×1.0 cm to 4.0 cm×2.5 cm. And the size of the flap ranged from 2.5 cm×1.5 cm to 4.5 cm×3.0 cm. All wounds at donor sites were sutured directly.
All the 26 cases were followed up 4-12 months (mean, 7 months). The 24 flaps survived uneventfully after operation, and the wounds healed by first intention. Partial necrosis occurred at the distal part in 2 flaps, and secondary healing achieved after debridement and dressing. All incisions at donor sites healed by first intention. The appearance and texture of all flaps were satisfactory. The two-point discrimination of the flaps was 5-10 mm (mean, 8 mm) at 4 months after operation. Sensory of the flaps was grade S . Only linear scar was noted at the donor site.
The radial-lateral forearm free perforator flap in repairing of the soft tissues in finger can shorten the disease duration, reduce the damage of the donor site, and improve the patients' quality of life.
探讨前臂桡外侧游离穿支皮瓣修复手指软组织缺损的疗效。
2017年1月至2018年5月，采用以骨间后动脉桡侧支为蒂的前臂桡外侧游离穿支皮瓣治疗26例手指皮肤缺损患者。其中男21例，女5例，平均年龄26.6岁（19～56岁）。致伤原因：切割伤16例，挤压伤10例。受伤至入院时间为30分钟至4小时（平均1.5小时）。损伤位于拇指6例，示指8例，中指6例，环指3例，小指3例；位于手指背侧6例，外侧6例，掌侧14例。所有创面均伴有肌腱及骨质外露，10例伴有指骨骨折。缺损面积为2.0 cm×1.0 cm至4.0 cm×2.5 cm。皮瓣面积为2.5 cm×1.5 cm至4.5 cm×3.0 cm。供区创面均直接缝合。
26例均获随访，随访时间4～12个月（平均7个月）。术后24例皮瓣顺利成活，创面一期愈合。2例皮瓣远端部分坏死，经清创换药后二期愈合。供区切口均一期愈合。所有皮瓣外观及质地满意。术后4个月皮瓣两点辨别觉为5～10 mm（平均8 mm），感觉为S级。供区仅留线状瘢痕。
前臂桡外侧游离穿支皮瓣修复手指软组织缺损可缩短病程，减少供区损伤，提高患者生活质量。
