邻指皮瓣修复伴有骨、肌腱外露的手指软组织缺损体会(1)-找论文网

【摘要】目的总结运用邻指皮瓣修复手指软组织缺损的经验及体会。方法对56例外伤后伴有骨或（和）肌腱外露的手指软组织缺损运用邻指皮瓣进行修复。结果早期5例因皮瓣蒂部较短且较厚致断蒂时仍存在缺损，经换药后愈合；1例因固定不佳致皮瓣部分撕裂经仔细再固定后愈合；1例植皮区受压时间过长出现坏死经二次植皮后恢复。后期病例未出现意外，皮瓣全部存活。结论邻指皮瓣在修复手部软组织缺损中具有操作简单、费用低廉、效果显著等优点，但是手术技巧的掌握对疗效有较大影响。

【关键词】手外伤；外科皮瓣；手术技巧

The experience of using the cross-finger flap to repair the soft tissue defect in fingers

【Abstract】 Objective To summarize the experience of using the cross-finger flap to repair the soft tissue defect in fingers. Methods 56 injured cases with soft tissue defect complicated bone or(and) tendon exposure were repaired by cross-finger flap. Results The earlier period of 5 cases remained defect as the pedicle relatively short and thick,which healed through change of dressings.One case was partially torn for the deficient of fixation,and healed after refixation.One case’s recipient skin graft necrosed because of long duration of compression and recovered after the second time skin graft.The later period the flaps were survived totally without any unexpectedness. Conclusion The cross-finger flap posses the advantages of easy to manage,economic,and significant effectiveness for repairing the soft tissue defect in fingers.But the effect was influenced greatly by the operative skill.

【Key words】 surgical flap;finger injury;operative skill

随着社会流动性的增加，外来民工技能培训的匮乏，机器操作的不熟练，手部外伤机会大大增加。2001年4月～2004年6月，我科对56例59指外伤性伴有骨或（和）肌腱外露的手指软组织缺损行邻指皮瓣修复术，效果满意。报告如下。

1 临床资料

1.1 一般资料本组共56例59指，男47例50指，女9例9指，年龄16～42岁，平均年龄26岁，电刨伤43例，其他原因13例，均伴有肌腱或（和）指骨外露。56例均为拇指末端背侧缺损较多及其他各指末节或（和）腹侧软组织缺损。拇指腹侧缺损较多者采用其他方法予以修补。全部门诊治疗。

1.2 手术方法皮瓣切取区范围为近、中节指骨背侧皮肤，远近端不超过指间关节，内外端不超过指侧的中点，皮瓣保留指浅表静脉组织，注意保留腱膜表面软组织。采用侧方为蒂的邻指皮瓣42例，近端为蒂的邻指皮瓣13例，远端为蒂的邻指皮瓣5例。术后3周断蒂，同时注意修复手指外形。

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