目的 分析指固有动脉背侧支血管链蒂逆行岛状皮瓣修复指端缺损的近期疗效,并总结治疗体会.方法 回顾性分析 21 例(21 指)指端缺损患者的临床资料,患者均行指固有动脉背侧支血管链蒂逆行岛状皮瓣修复.随访评估患者的主观满意度、皮瓣感觉恢复情况、患指活动功能.结果 术后 19 例患者皮瓣完全成活并顺利拆线,1 例因术后私自吸烟致皮瓣严重发绀延迟愈合,1 例因术后私自开空调温度过低致皮瓣部分坏死.21 例患者中共 19 例获得随访,随访时间 3~18 个月,平均(8.9±4.6)个月.获得随访患者中,患者的主观满意度:很满意 16 例(84.2%)、比较满意 3 例(15.8%),无不满意病例.皮瓣感觉恢复情况:S4 15 例(78.9%),S3+ 3 例(15.8%),S3 1 例(5.3%).患指活动功能:优16 例(84.2%),良 3 例(15.8%).结论 指固有动脉背侧支血管链蒂逆行岛状皮瓣修复指端缺损外形功能满意,优势明显,术后积极处理和密切护理对于术后良好疗效亦至关重要.
Objective To analyze the short-term efficacy of reverse island flaps based on vascular chain between the dorsal branches of the digital artery for repairing the defects of finger tips,and review the treatment experiment.Methods Retrospective analysis was made on clinical data of 21 patients(21 fingers)with finger tip defect.All patients were repaired by reverse island flaps based on vascular chain between the dorsal branches of the digital artery.The subjective satisfactions,sensory of flap,activity function of the affected finger were assessed during follow-up.Results 19 flaps were fully viable and the sutures were removed successfully,1 case delayed in healing due to severe cyanosis caused by postoperative smoking,another 1 case got partial necrosis because of opening air conditioning,which leading to low temperature.19 of 21cases were followed up ranging from 3 to 18 months,with an average of(8.9±4.6)months.In the follow-up cases,the subjective satisfaction of patients:very satisfied in 16 cases(84.2%),relatively satisfied in 3 cases(15.8%),and there were no unsatisfied cases.Flap sensory recovery:S4 in 15 cases(78.9%),S3+ in 3 cases(15.8%),S3 in 1 case(5.3%).Activity function of the affected finger:excellent in 16 cases(84.2%),good in 3 cases(15.8%).Conclusion Reverse island flaps based on vascular chain between the dorsal branches of the digital artery for repairing defect of finger tip can reach good texture and contour,and has a clear advantage.But dealing with complications actively and the close nursing postoperatively are remain essential for a good clinical outcome.