Voche P, Merle M
Department of Plastic and Reconstructive Surgery of the Locomotor Apparatus, CHRU Nancy, Hôpital Jeanne d'Arc, Dommartin les Toul, France.
Br J Plast Surg. 1994 Sep;47(6):435-9. doi: 10.1016/0007-1226(94)90074-4.
The authors propose a volar subcutaneous pedicled flap to cover skin defects over the dorsum of the same finger. This flap includes all the subcutaneous (adipofascial) tissues from the reticular dermis to the synovial sheath of the flexor tendons. After elevation of the dermo-epidermal flap, the subcutaneous tissues are raised as a flap pedicled laterally on one of the collateral arteries which constitutes the axis of rotation and transposition. After release of the collateral neurovascular bundle from its connections with the skeleton, the skin and the synovial sheath, the flap can be transposed to the dorsum of the finger and then covered with a split thickness skin graft. The advantages of this technique are: (1) No functional or cosmetic sequelae at the donor site which is closed by the volar dermo-epidermal flap; (2) Homodigital flap. This is particularly helpful in cases of multidigit involvement where cross-finger flaps cannot be performed; (3) Vascular reliability; (4) Preservation of both collateral arteries.
作者提出一种掌侧皮下带蒂皮瓣来覆盖同一手指背侧的皮肤缺损。该皮瓣包括从网状真皮到屈肌腱滑膜鞘的所有皮下（脂肪筋膜）组织。在掀起真皮表皮瓣后，将皮下组织作为皮瓣掀起，其蒂位于构成旋转和转移轴的一条侧副动脉的外侧。在将侧副神经血管束与其与骨骼、皮肤和滑膜鞘的连接分离后，皮瓣可转移至手指背侧，然后用断层皮片覆盖。该技术的优点包括：（1）供区无功能或美容后遗症，供区由掌侧真皮表皮瓣关闭；（2）同指皮瓣。这在多手指受累且无法进行邻指皮瓣手术的情况下特别有用；（3）血管可靠性；（4）保留两条侧副动脉。
