Chen H C, Tang Y B, Chuang D, Wei F C, Noordhoff M S
Department of Plastic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Ann Plast Surg. 1996 May;36(5):542-50. doi: 10.1097/00000637-199605000-00018.
The posterior interosseous flap has been used as a pedicled flap for coverage of hand wounds. However, the pedicled flap is associated with partial or even complete loss when there is venous congestion. This happens because it depends on retrograde venous drainage. Another pitfall of the pedicled posterior interosseous flap is the undetected damage to the communicating vessels between the anterior and posterior interosseous arteries before surgery. This would result in failure if the flap is used as a distally based flap. Thirty-four patients had been reconstructed with the microvascular free posterior interosseous flap. The free flap has a large draining vein. Flap survival rate was 97%. There was no venous congestion and no partial loss of the flap. It is thin, sensate, and reliable. The free posterior interosseous flap is indicated for coverage of the following wounds: (1) first web space and thumb, (2) radial side of the index and ulnar side of the small finger if a cross-finger flap cannot be used, and (3) defects at the dorsum of multiple fingers. It can also be used as a free fascial flap. The free posterior interosseous flap provides a reliable option for coverage of hand wounds. Previously, another 14 patients with hand wounds had been reconstructed with a pedicled posterior interosseous flap. The results of pedicled and free posterior interosseous flaps are compared.
骨间后皮瓣已被用作带蒂皮瓣来覆盖手部伤口。然而，当出现静脉淤血时，带蒂皮瓣会出现部分甚至完全坏死。这是因为它依赖于逆行静脉引流。带蒂骨间后皮瓣的另一个缺陷是术前未察觉骨间前、后动脉之间交通支的损伤。如果将该皮瓣用作远端蒂皮瓣，这将导致手术失败。34例患者采用游离骨间后微血管皮瓣进行了修复重建。游离皮瓣有一条粗大的引流静脉。皮瓣成活率为97%。未出现静脉淤血，皮瓣也没有部分坏死。它薄、有感觉且可靠。游离骨间后皮瓣适用于覆盖以下伤口：（1）第一掌骨间隙和拇指；（2）如果不能使用邻指皮瓣，示指桡侧和小指尺侧；（3）多个手指背侧的缺损。它也可用作游离筋膜皮瓣。游离骨间后皮瓣为手部伤口的覆盖提供了一种可靠的选择。此前，另有14例手部伤口患者采用带蒂骨间后皮瓣进行了修复重建。对带蒂和游离骨间后皮瓣的结果进行了比较。
