Ninkovíc M M, Schwabegger A H, Wechselberger G, Anderl H
University Clinic for Plastic and Reconstructive Surgery, Innsbruck, Austria.
J Hand Surg Br. 1997 Oct;22(5):623-30. doi: 10.1016/s0266-7681(97)80361-0.
The reconstruction of large palmar defects of the hand remains a difficult problem due to the specific anatomical structures and highly sophisticated function of the palm. The glabrous skin and subcutaneous tissue in the palm are perfectly adapted to serve the prehensile function. The particular aim must be that repairs to this functional structure are similar in texture and colour and are aesthetically acceptable. Restoration of sensibility is desirable. For smaller defects a great variety of local pedicled or island flaps can be applied. However, for larger defects with exposed tendons, nerves or other essential structures, free flaps remain as a reliable alternative. This paper reviews our approach of soft tissue reconstruction in 16 patients with large palmar defects using various kinds of free flaps. The advantages, disadvantages and current indications for free flap resurfacing of the palm are discussed.
由于手掌特定的解剖结构和高度复杂的功能，手部大的掌侧缺损修复仍然是一个难题。手掌无毛皮肤和皮下组织完美适应抓握功能。修复这一功能结构的特定目标必须是在质地和颜色上相似且美学上可接受。恢复感觉功能是可取的。对于较小的缺损，可以应用多种局部带蒂或岛状皮瓣。然而，对于伴有肌腱、神经或其他重要结构外露的较大缺损，游离皮瓣仍是一种可靠的选择。本文回顾了我们使用各种游离皮瓣对16例手掌大缺损患者进行软组织重建的方法。讨论了游离皮瓣修复手掌的优缺点及当前适应证。
