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带指固有神经背侧支筋膜皮瓣修复手指软组织缺损
http://www.100md.com 《创伤外科杂志》 2007年第2期
软组织缺损;皮瓣;筋膜;手指,,软组织缺损;皮瓣;筋膜;手指,关键词:软组织缺损;皮瓣;筋膜;手指,临床资料,1一般资料,2手术方法,3术后处理,讨论,1应用解剖,2与其他皮瓣比较,3适应证,4本术式特点,5注意事项,6本术式优点,参考文献:
     摘要: 目的 探讨以伤指指背筋膜为蒂、带指固有神经背侧支的岛状皮瓣顺行或逆行转移修复指背或指腹软组织缺损的方法。方法 2005年1月~2006年8月,收治17例22指中末节外伤软组织缺损,应用沿手指近、中节背侧指固有神经背侧支行走方向,设计并切取筋膜蒂皮瓣,修复缺损。切取皮瓣时蒂部带一矩形皮瓣,以减轻转位后皮瓣蒂部的张力。皮瓣顺行转移时不需缝合神经,逆行转移时与受区神经缝合。皮瓣切取范围不超过手指侧中线,切取面在腱周浅层,皮瓣转移轴线沿指固有神经背侧支走向。结果 本组17例22指皮瓣全部成活。结论 采用带指固有神经背侧支的筋膜岛状皮瓣转移修复指腹或指背皮肤软组织缺损,是一种简单、安全,行之有效的手术方法。

    关键词:软组织缺损;皮瓣;筋膜;手指

    Homodigital dorsal fascia island flap for repair of dorsal or palmer soft tissue defect of the injured finger

    LI Degui,ZUO Zhongnan,LI Qingsheng,et al.

    (Department of Hand and Foot plastic Surgery,First People's Hospital of Foshan,Foshan 528000,China)

    Abstract: Objective To introduce a method for repairing dorsal or palmer soft tissue defect of the injured finger by using homodigital anterograde and retrograde dorsal fascia island flap,which includes the dorsal branch of the digital proper nerve.Methods The flap was designed at the dorsum of the middle and proximal phalanx along the dorsal branch of (proper) digital proper nerve,it contained a rectangular skin pedicle for reducing tension at the site of pedicle.Neurosuture was unnecessary in anterograde flap,and in retrograde flap,we sutured digital nerve with the dorsal branch nerve of flap.Results All twentytwo digital skin flaps of 17 cases survived.Conclusion The homodigital dorsal fascia island flap is a simple,safe and effective method for reconstructing the defect of soft tissue at the dorsum or palmer side of the injured finger. ......

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