中国临床康复2005，Vol.9Issue(14)：254-256,3.
前臂静脉皮瓣对手指离断合并皮肤缺损的修复及术后功能恢复
Forearm venous flap for soft-tissue reconstruction in digit amputation and postoperative rehabilitation
史德海 1蔡道章 1徐义春 1戎利民 1王昆 1程立明1
作者信息
- 1. 中山大学附属第三医院骨科,广东省,广州市,510630
- 折叠
摘要
Abstract
BACKGROUND: Digit amputation coupled with neighboring composite skin loss frequently occurs. Conventional treatment for this lesion is somewhat less desirable in that it either results in shortened or lost fingers as well as delayed skin resurfacing. Therefore, the curative effect is not satisfactory.OBJECTIVE: To observe free forearm venous flap for soft-tissue reconstruction in digit amputation accompanied with neighboring soft tissue loss and postoperative rehabilitation and its effect on functional recovery.DESIGN: Before-and-after controlled observational trial based on the patients.SETTING: Department of orthopedics of a university hospital.PARTICIPANTS: Totally 11 patients, 8 males and 3 females aged 20 to 45years, who were treated between October 2000 and May 2004 in the Department of Orthopedics, Third Affiliated Hospital of Sun Yat-sen University,for digit amputations accompanied with composite skin flaps avulsed in dorsal fingers or hand, were recruited.METHODS: Eleven free venous flaps measuring 1. 5 cm × 1.0 cm to 5 cm × 6. 5 cm from anteromedial ipsilateral forearms were elevated and transferred to the defected sites either antegradely or retrogradely with respect to the nature of the defects. Microvascular anastomosis was performed at both ends of the flaps to the wounds in an end-to-end fashion. Digit replantations in 13 digits were performed simultaneously at one stage. The donor sites were closed primarily by direct suturing or skin grafting. After operation, early rehabilitation was initiated under professional guidance.RESULTS: Complete healing was achieved in 9 out of 11 venous flaps and 12 out of 13 replanted digits. After one-year follow-up, finger motion function in seven cases was satisfactory; however, all the flaps presented diminished sensation.CONCLUSION: The free venous flap from anteromedial forearm is an alternative flap for soft-tissue reconstruction in digit amputation. Easy access,ideal thickness, and good pliability are the advantages of the flap whereas limited sensory recovery is the main shortcoming.关键词
指损伤/再植术/软组织损伤/外科皮瓣分类
医药卫生引用本文复制引用
史德海,蔡道章,徐义春,戎利民,王昆,程立明..前臂静脉皮瓣对手指离断合并皮肤缺损的修复及术后功能恢复[J].中国临床康复,2005,9(14):254-256,3.
