He Bo, Liu Jianghui, Pang Vincent, Zhu Lei, Huang Yongjun, Wang Zengtao, Xu Yangbin, Zhu Zhaowei, Wang Kun
From the Department of Orthopedics, The Third Affiliated Hospital of Sun Yat-Sen University.
Departments of Emergency Medicine.
Ann Plast Surg. 2019 Dec;83(6):664-669. doi: 10.1097/SAP.0000000000001933.
The reconstruction of finger defects requires improved functional outcomes and acceptable esthetic outcomes, and small free flaps present a good alternative technique for repairing finger skin defects. From January 2006 to December 2018, we investigated the number and diameter of proximal digital artery perforators, medial plantar artery perforators, and peroneal proper plantar digital arteries of the hallux by dissection and then transplanted free digital arterial perforator flaps, free medial plantar flaps, and free peroneal flaps from the hallux to repair small finger skin defects. The number (SD) of perforators from the medial plantar artery was approximately 2.2 (0.5), and these perforators measured 0.53 (0.20) mm in diameter. The diameter (SD) of the first metatarsal dorsal artery was approximately 1.16 (0.30) mm. A total of 25 patients were included in this study. The transplantation times (SD) for free digital arterial perforator flaps, free medial plantar flaps, and free peroneal flaps from the hallux were 3.5 (0.5) hours, 3.2 (0.7) hours, and 2.0 (0.4) hours, respectively. The follow-up period ranged from 8 to 15 months. All flaps survived and were appropriately shaped. The donor site was either covered with a free flap or directly sutured. Among these 3 types of small flaps, the free peroneal flap from the hallux can be recommended for clinical use because of the large diameter of the contributing vessels, the short operative time, the ease of access, and the improved appearance of the donor site.
手指缺损的修复需要改善功能预后和获得可接受的美学效果，而小型游离皮瓣是修复手指皮肤缺损的一种良好替代技术。2006年1月至2018年12月，我们通过解剖研究了拇趾的指近节动脉穿支、足底内侧动脉穿支和足底固有腓动脉的数量和直径，然后将游离指动脉穿支皮瓣、游离足底内侧皮瓣和来自拇趾的游离腓皮瓣移植用于修复手指小面积皮肤缺损。足底内侧动脉穿支的数量（标准差）约为2.2（0.5）个，这些穿支的直径为0.53（0.20）mm。第一跖背动脉的直径（标准差）约为1.16（0.30）mm。本研究共纳入25例患者。来自拇趾的游离指动脉穿支皮瓣、游离足底内侧皮瓣和游离腓皮瓣的移植时间（标准差）分别为3.5（0.5）小时、3.2（0.7）小时和2.0（0.4）小时。随访时间为8至15个月。所有皮瓣均存活且外形合适。供区要么用游离皮瓣覆盖，要么直接缝合。在这3种小型皮瓣中，来自拇趾的游离腓皮瓣因其供血血管直径大、手术时间短、易于切取以及供区外观改善，可推荐临床使用。
