组织工程与重建外科杂志2026，Vol.22Issue(1)：73-77,5.DOI:10.3969/j.issn.1673-0364.2026.01.009
拱顶石穿支岛状皮瓣在肢体末端中小面积创面修复中的应用
Application of keystone perforator island flap in repairing medium and small-sized wounds at the distal extremities
摘要
Abstract
Objective To explore the clinical efficacy of keystone perforator island flap in repairing medium and small-sized wounds at the extremities.Methods A retrospective analysis was conducted on the clinical data of 20 patients with medium and small-sized wounds at the extremities(hands and ankle feet)who underwent keystone perforator island flap repair from January 2019 to December 2023.Among them,there were 13 males and 7 females,with ages ranging from 26 to 65 years old.The wound area was 0.5 cm×0.8 cm to 3.0 cm×4.5 cm,and the area of the excised flap was 0.8 cm×2.0 cm to 3.5 cm×7.0 cm.Before the operation,high-frequency color Doppler ultrasound was used to detect the perforator vessels around the proposed flap and mark them on the skin surface to pre-plan the flap excision range.During the operation,the excised flap was advanced to repair the wound,and the donor site was sutured directly after tension reduction.The flap survival and donor site wound healing were observed.At the last follow-up,the two-point discrimination of the hand flaps was measured,and the overall appearance of the flaps and donor sites was evaluated using the Vancouver scar scale(VSS).Results All 20 flap surgeries were successfully completed.Among them,19 flaps survived in the first stage,and 1 flap had partial necrosis at the edge after the operation,which gradually healed after dressing changes.All donor site wounds healed in the first stage.The follow-up period was 12 to 20 months.At the last follow-up,the two-point discrimination of the hand flaps was 3 to 6 mm,with an average of(4.13±0.83)mm.The two-point discrimination of the ankle and foot flaps was 12 to 17 mm,with an average of(14.8±1.92)mm.The overall appearance of the flaps and donor sites was scored 2 to 8 points on the VSS,with an average of(5.25±1.40)points.Conclusion The keystone perforator island flap for repairing medium and small-sized wounds at the extremities has reliable blood supply,simple operation,minimal secondary injury,and good appearance and function recovery.关键词
外科皮瓣/穿支皮瓣/拱顶石/创面修复/四肢损伤Key words
Surgical flap/Perforator flap/Keystone/Wound repair/Limb injury分类
医药卫生引用本文复制引用
孙鑫洋,戴江平,王海峰,樊曦,王辉..拱顶石穿支岛状皮瓣在肢体末端中小面积创面修复中的应用[J].组织工程与重建外科杂志,2026,22(1):73-77,5.基金项目
河北省医学科学研究计划项目(20240654) （20240654）
唐山市科技计划项目(22150219J). （22150219J）
