角形筋膜皮穿支皮瓣修复手指软组织缺损的解剖学基础及临床应用

中华整形外科杂志 Pub Date : 2016-09-01
Yu Wang, Xiaojing Li, Xinyi Li, Jinlong Ning, Demeng Ma, Huairui Cui, Jun Zheng
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引用次数: 0

摘要

目的:探讨角穿支皮瓣治疗手指软组织缺损的临床效果。方法:①对4具新鲜成人尸体进行氧化铅明胶混合物注射和CT扫描,并将数据放入mimics 17.0中进行三维重建。观察了指掌固有动脉穿支的分布规律和起源。②2012年7月~ 2015年7月,对9例手指软组织缺损采用角穿支皮瓣修复。缺损面积为0.6 cm× 0.8 cm ~ 1.2 cm× 1.5 cm,皮瓣大小为0.8 cm×2.5 cm ~ 1.6 cm×4.2 cm。我们把皮瓣的头端放在有缺陷的一边。角穿支皮瓣设计1-2支穿支血管,旋转覆盖缺损。供体部位的缺损直接闭合。结果:在指掌面和指背面得到对称动脉4条,掌指正动脉2条,指背动脉2条。指掌固有动脉直径较大,是手指血液供应的主要来源。手术后9个皮瓣全部存活。受体和供体均愈合良好。随访2个月~ 1年半,形态、色泽、肌理、功能均恢复良好。结论:采用角状穿支皮瓣修复手指软组织缺损,设计灵活,穿支血管可靠。供区缺损可直接闭合,无需植皮。该方法兼顾了形状和功能,是修复手指软组织缺损的好方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[The anatomy basis and clinical application of the horn fasciocutaneous perforator flaps for the reconstruction of the defects on finger soft tissue].

Objective: To discuss the clinical effect of horn perforator flaps for the treatment of finger soft tissue defect.

Methods: ① Lead oxide-gelatin mixture injection and CT scanning were performed in 4 fresh adult cadavers and the data was put into mimics 17.0 to achieve the three-dimensional reconstruction. The regulation and origins of the perforator vessel in proper palmar digital artery was observed. ② From July 2012 to July 2015,9 cases with finger soft tissue defects were treated with horn perforator flaps. The defect areas ranged from 0.6 cm × 0.8 cm to 1.2 cm × 1.5 cm and the flap size ranged from0.8 cm×2.5 cm to 1.6 cm×4.2 cm. We put the head end of flaps at defect side. The horn perforator flap was designed with 1-2 perforator vessel and rotated to cover the defect. The defect at donor site was closed directly.

Results: We got 4 symmetric arteries in palmar and back surfaces of fingers,2 for proper palmar digital arteries and 2 for dorsal digital arteries. The proper palmar digital arteries have a larger diameter which is the main source of blood supply for fingers. All 9 flaps survived after the operation. Both the recipient area and donor areas received sound healing. With 2 months to 1.5 years of follow-up visit, the shape, color and luster, texture and function all had good healing.

Conclusions: The horn perforator flaps for repair finger soft tissue defect have advantages of flexible design, reliable perforator vessels. The defect at donor site can be closed directly with no skin graft. This method considers both shape and function and is a good way for finger soft tissue defect.

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