Clinical effects of modified fascia flap from cutaneous branch of dorsal metacarpal artery in repairing the wound at the proximal and middle finger segments
-
摘要: 目的 探讨改良掌背动脉皮支筋膜蒂皮瓣修复手指近、中节创面的临床效果。 方法 2017年1月—2018年9月,遵义医科大学附属医院收治12例手指近、中节创面患者,其中男8例、女4例,年龄35~70岁,创面面积为3.4 cm×2.4 cm~6.5 cm×4.0 cm。采用改良掌背动脉皮支筋膜蒂皮瓣修复创面,皮瓣切取面积为3.5 cm×2.5 cm~6.7 cm×4.1 cm。5例患者皮瓣供区直接间断缝合,4例患者皮瓣供区取同侧前臂内侧全厚皮片修复,3例患者皮瓣供区采用腕部带蒂皮瓣修复。记录皮瓣存活情况,随访观察供受区恢复情况,采用中华医学会手外科学会上肢部分功能评定试用标准评定手功能。 结果 12例患者皮瓣全部成活。随访3~12个月,皮瓣质地、外形恢复较佳,11例患者供区愈合;1例患者供区植皮边缘区域部分坏死,经换药后愈合。本组患者皮瓣两点辨别觉距离为5.6~9.0 mm,手功能评定为优5例、良4例、中3例。 结论 改良掌背动脉皮支筋膜蒂皮瓣修复手指近、中节创面血运可靠,手术操作简便、安全,疗程短,值得临床推广。Abstract: Objective To investigate the clinical effects of modified fascia flap from cutaneous branch of dorsal metacarpal artery in repairing the wound at the proximal and middle finger segments. Methods From January 2017 to September 2018, 12 patients with wounds at the proximal and middle finger segments were admitted to the Affiliated Hospital of Zunyi Medical University, including 8 males and 4 females, aged 35-70 years. The areas of wounds ranged from 3.4 cm×2.4 cm to 6.5 cm×4.0 cm. The modified fascia flaps from cutaneous branch of dorsal metacarpal artery were resected to repair the wounds, with the size ranging from 3.5 cm×2.5 cm to 6.7 cm×4.1 cm. The flap donor sites of 5 patients were repaired with direct intermittent suture, the flap donor sites of 4 patients were repaired with full-thickness skin grafts from ipsilateral medial forearm, and the flap donor sites of 3 patients were repaired with wrist pedicled flaps. The survival of the flaps was recorded. Healing of donor site and recipient site was followed. The hand functions were evaluated with trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association. Results All the flaps survived in 12 cases. During 3 to 12 months of follow-up, the flaps recovered satisfactorily in texture and shape. The donor sites of 11 patients were healed, and the skin graft edge area was partially necrotic in the other patient but healed later after dressing change. The distances of two-point discrimination of the patients ranged from 5.6 to 9.0 mm. Hand functions were evaluated as excellent in 5 cases, good in 4 cases, and fair in 3 cases. Conclusions Modified fascia flap from cutaneous branch of dorsal metacarpal artery for repairing the wounds at the proximal and middle finger segments has reliable blood supply. The operation is simple and safe with short course of treatment, which is worthy of clinical promotion.
-
Key words:
- Surgical flaps /
- Wound healing /
- Fingers /
- Dorsal palmar artery
点击查看大图
计量
- 文章访问数: 91
- HTML全文浏览量: 8
- PDF下载量: 25
- 被引次数: 0