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采用上臂外侧游离皮瓣临时并指术修复多个手指缺损

Reconstruction of Multiple Digital Defects by Temporary Syndactylization Using a Lateral Arm Free Flap.

作者信息

Ki Sae Hwi, Yoon Jin Myung, Park Tae Jun, Choi M Seung Suk, Hong Min Ki

机构信息

Department of Plastic and Reconstructive Surgery, Inha University Hospital, Incheon, People's Republic of Korea.

Department of Plastic and Reconstructive Surgery, School of Medicine, Inha University, Incheon, People's Republic of Korea.

出版信息

Arch Plast Surg. 2022 Dec 13;49(6):745-749. doi: 10.1055/a-1938-0691. eCollection 2022 Nov.

Abstract

Soft tissue defects of the multiple finger present challenges to reconstruction surgeons. Here, we introduce the use of a lateral arm free flap and syndactylization for the coverage of multiple finger soft tissue defects.  This retrospective study was conducted based on reviews of the medical records of 13 patients with multiple soft tissue defects of fingers (  = 33) that underwent temporary syndactylization with a microvascular lateral arm flap for temporary syndactylization from January 2010 to December 2020. Surgical and functional outcomes, times of flap division, complications, and demographic data were analyzed.  Middle fingers were most frequently affected, followed by ring and index fingers. Mean patient age was 43.58 years. The 13 patients had suffered 10 traumas, 2 thermal burns, and 1 scar contracture. Release of temporary syndactyly was performed 3 to 9 weeks after syndactylization. All flaps survived, but partial necrosis occurred in one patient, who required a local transposition flap after syndactylization release. The mean follow-up was 15.8 months.  Coverage of multiple finger defects by temporary syndactylization using a free lateral arm flap with subsequent division offers an alternative treatment option.

摘要

多指软组织缺损给重建外科医生带来了挑战。在此,我们介绍使用侧臂游离皮瓣和并指术来覆盖多指软组织缺损。

本回顾性研究基于对2010年1月至2020年12月期间13例手指多处软组织缺损(n = 33)患者的病历回顾进行,这些患者接受了带微血管的侧臂皮瓣临时并指术。分析了手术和功能结果、皮瓣分指时间、并发症和人口统计学数据。

中指受累最为常见,其次是环指和示指。患者平均年龄为43.58岁。这13例患者中,有10例遭受创伤,2例热烧伤,1例瘢痕挛缩。并指术后3至9周进行临时并指松解。所有皮瓣均存活,但1例患者出现部分坏死,在并指松解后需要局部转位皮瓣。平均随访时间为15.8个月。

使用游离侧臂皮瓣进行临时并指,随后分指,以此覆盖多指缺损,提供了一种替代治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73ec/9747283/d14b4f4fc462/10-1055-a-1938-0691-i22apr0064oa-1.jpg

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