【摘要】 目的探讨一蒂串联皮瓣在手外科的应用价值。方法临床应用胫前-足背动脉及伴行静脉为蒂的前踝上皮瓣及足背皮瓣4例,胫后-足底内侧动脉及其伴行静脉为蒂的小腿内侧皮瓣、足内侧皮瓣5例。皮瓣的平均面积依次分别为16cm×8cm、15cm×7cm、10cm×9cm和9cm×6cm。结果9个病人所有皮瓣全部成活,较好地覆盖了手掌及手背或前臂大面积皮肤缺损。皮瓣质地薄,不臃肿。结论一蒂串联皮瓣是修复大面积手掌、手背皮肤缺损的有效方法;具有手术风险相对较低,手术成功率高的优点;但由于对小腿及足破坏较大应严格掌握适应证。更多还原

【Abstract】 Objective To explore applicative merit of tandem skin flaps with a common vascular pedicle in hand surgery.Methods Anterior supramalleolar flap and dorsalis pedis flap based on anterior tibial-dorsal pedal artery and venae comitantes were used in 4 patients,and medial flap of the leg and medial pedal flap based on posterior tibial-medial plantar vascular system were used in 5 cases in order to repair big skin defects in dorsum and palm of hand.The average areas of the flaps respectively were 16cm×8cm?15cm×7cm?10cm×9cm and 9cm×6cm respectivel.Results All flaps survived completely in 9 patients,and the big skin defects in palm and dorsum of hand or forearm were covered better.The texture of flap was good and thin without excessive fats.Conclusion With advantage of relatively low operative risk and high operative achievement ratio,tandem skin flaps with a common vascular pedicle is an effective method for repairing big skin defects in palm and dorsum or forearm.However,it may result in bigger damage to foot,so its indication should be selected strictly.更多还原