手部带感觉的岛状皮瓣急诊修复拇指指腹缺损

【作者】 余建新； 薛旦； 张华辉； 胡学庆； 马奇；

【机构】 浙江大学医学院附属二院；

【摘要】 目的探讨拇指指腹缺损的急诊(Ⅰ期)修复的手术选择。方法 2003年5月至2007年6月在急诊I期修复的拇指指腹缺损病例42例,采用手部带感觉的岛状皮瓣对拇指指腹缺损的修复,其中示指背侧带蒂旋转皮瓣修复21例,大鱼际桡侧岛状皮瓣修复13例,中、环指岛状皮瓣修复9例。结果所有皮瓣均成活,指腹饱满,1例示指背侧岛状皮瓣和2例大鱼际桡侧岛状皮瓣修复术后第一天,出现皮瓣肿胀、瘀紫、毛细血管充盈反应迅速,将其蒂部转移轴点处过紧缝线部分拆除后缓解。并有保护性感觉,两点辨别觉在3-7mm之间,指间关节伸屈自如。结论应用带感觉的岛状皮瓣是修复拇指指腹缺损,不仅修复了拇指缺损,而且恢复拇指感觉,对拇指的功能有重要的意义。更多还原

【Abstract】 Objective To evaluate the effect of reparing the emergency thumb pulp defect by transfering hand sensate island flaps.Method From May,2003 to June, 2007.The authors carried out 42 cases of emergency thumb pulp defect reconstruction by using hand sensate island flaps.Of them,Index finger dorsal island flap was performed in 21 cases,radial border reverse island flap of great thenar in 13 cases,middle or ring finger island flap in 9 cases.Results All flaps were survived with good sensation,static two-point discrimination measuring from 3mm to 7mm.3 cases suffered transient postoperative swelling and ecchymosis due to pedical compression by tight suturing.After surgery,interphalangeal joint functioned well.Conclusions Hand sensate island flaps transferring was a better choice in the treatment of emergency thumb pulp defect because it rebuilded the sensory function.更多还原