朱　云　刘　毅　张鲜英　钟晓玲

朱云,1964年生,汉族,湖北人,1987年毕业于第三军医大学医学系,1994年获硕士学位。现任兰州军区总医院烧伤整形科主治医师,从事烧伤整形美容临床工作12年,发表论文10余篇。摘要目的:探讨血管神经蒂食指背筋膜岛状皮瓣的应用效果。方法:采用食指背侧筋膜蒂岛状皮瓣对10例拇指软组织缺损,2例虎口软组织缺损进行了修复,结果:修复后的拇指或虎口外形较好,功能恢复满意,皮瓣厚薄适中,色泽质地良好。结论:该皮瓣具有多源性血供的特点,不因第一掌背动脉的类型及出现率不稳定而影响手术成败,是修复拇指、虎口皮肤缺损的理想皮瓣。

关键词食指掌背动脉筋膜皮瓣皮肤缺损CLINICAL APPLICATION OF THE VASCULAR睳ERVE

PEDICLE ISLAND FASCIAL FLAP IN DORSAL INDEX FINGER

Zhu YunLiu YiZhang Xianying,et al

Department of Burn and plastic

surgery,Lanzhou General Hospital of PLA(Lanzhou 730050)

AbstractObjective:To investigate the effect of clinical application of vascular瞡erve pedicle island fascial flap in dorsal index finger. Methods;The flaps have been used to repair the soft tissue defect in thumb of 10 cases and in first finger web of 2 cases. Results:Post瞣perative the pearance and function were satisfactoery in all casese.The flap has appropriate thickness and good skin texture with well瞞atched color. Conclusion:The flap has the characteristic of many瞫ided blood supply.The operation is high rate of success and not related with the types, the display瞨ate of first dorsal metacar瞤ophalangeal artery. The flap has good blood supply,so it is the ideal donor site for soft tissue defects of thumb and first finger web.

Key wordsIndex fingerDorsal metacar瞤ophalangeal arteryFascial flapSkin defect

我科1994年～1998年,应用食指背侧岛状筋膜血管神经蒂皮瓣修复拇指及虎口软组织缺损12例,均获成功,外形及功能满意。

1临床资料

1.1本组男10例,女2例,年龄5岁～36岁。拇脂及虎口皮肤软组织缺损的原因:爆炸伤2例,绞窄伤2例,皮肤撕脱伤3例,挤压伤1例,电击伤 2例,创伤后期修复2例。本组全部采用食指背侧筋膜神经血管蒂岛状皮瓣转移修复,应用方式见附表。

1.2典型病例男,5岁,右手火药爆炸伤,拇指背、指腹软组织缺损,指骨外露,中指末节指骨及甲床缺失(图1、2)。在臂丛阻滞下行右拇指、中指清创术,食指背侧筋膜蒂岛状皮瓣转移修复拇指软组织缺损,中指残端修整。供区行全厚皮片移植加压包扎,手术历时2小时。术后皮瓣成活良好,外形及功能恢复满意(图3、4、5)。……