【摘要】 目的　为手部皮肤软组织缺损探寻一种新的修复方法。方法　在 40侧人体上肢标本上 ,对骨间后血管及其返支的来源、走行、分支、分布及吻合情况进行解剖观察的基础上 ,设计以前臂骨间后血管及其返支为蒂的串连皮瓣。1998年 8月～ 2 0 0 0年 7月间临床应用此皮瓣逆行移位修复手背远侧及手指背侧皮肤缺损 17例。皮瓣范围最大 15 cm× 10 cm,最小 7cm× 5 cm。结果　术后随访 3周～ 6个月 ,除 1例皮瓣远端有 2 cm× 3cm坏死外 ,其余皮瓣全部成活 ,外观及功能满意。结论　此皮瓣不损伤肢体主要血管 ,血管蒂较长 ,皮瓣切取面积较宽 ,厚薄适中 ,可用于修复拇指、手背至手指近节背侧的皮肤软组织缺损。手术简便 ,效果良好。更多还原

【Abstract】 Objective To explore a new surgical approac h to repair skin and soft tissue defect of hands. Methods Based on the anatomic al study of the or igin, course, branch, distribution, and anastomosis of the posterior interosseou s artery and its recurrent branches in 40 upper limbs of cadaver s, the posterior forearm serial flap, pedicled with the posterior interosseous a rtery and its recurrent branches, was designed and applied clinically in 17 case s to repair the skin and soft tissue defect of hands from August 1998 to July 20 00. The size of flaps ranged from 7 cm×5 cm to 15 cm×10 cm. All of the cases w ere followed up for 3 weeks to 6 months. Results The anatomy study showed that the posterior forearm serial flap had long vascular pedicle, suitable thickness and large ski n area. The clinical application indicated that the flaps survived in 16 cases. But flap necrosis at the distal end, sized 2cm×3cm, was observed in one case, i n which the defect was repaired by delayed skin grafting, Conclusion The post erior forearm serial flap pedicled with the posterior interosseous artery and it s recurrent branch have the character of avoidance of sacrificing the major arte ries of the extremity, longer vascular pedicle, larger area and suitable thickne ss. The posterior forearm serial flap is a safe and easily manipulated surgical approach to repair the skin and soft tissue defect of the hands, especially of t he thumb, palm, and proximal part of the fingers.更多还原