上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (7): 992-.doi: 10.3969/j.issn.1674-8115.2011.07.027

• 论著（临床研究） • 上一篇    下一篇

前臂背侧骨间动脉穿支逆行岛状皮瓣修复手部皮肤和软组织缺损

郭晓波1, 苏薇洁2, 朱 文1, 马忠超1, 章一新2   

  1. 1.贵州省人民医院整形外科, 贵阳 550002； 2．上海交通大学 医学院附属第九人民医院整复外科, 上海 200011
  • 出版日期:2011-07-28 发布日期:2011-07-27
  • 通讯作者: 苏薇洁, 电子信箱: rosiesu2000@yahoo.com.cn。
  • 作者简介:郭晓波（1968—）, 男, 副主任医师；电子信箱: guoxiaobo168@163.com。

Repair of hand skin and soft tissue defect with reverse island forearm posterior interosseous flap

GUO Xiao-bo1, SU Wei-jie2, ZHU Wen1, MA Zhong-chao1, ZHANG Yi-xin2   

  1. 1.Department of Plastic and Reconstructive Surgery, the People's Hospital of Guizhou Province, Guiyang 550002, China；2.Department of Plastic and Reconstructive Surgery, the Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
  • Online:2011-07-28 Published:2011-07-27

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摘要：

目的 采用前臂背侧骨间动脉逆行岛状皮瓣修复手部不同部位的皮肤和软组织缺损，观察疗效并总结皮瓣特点和手术要点。方法 收集接受前臂背侧骨间动脉逆行岛状皮瓣修复手术的36例手部皮肤和软组织缺损患者的临床资料，对修复部位、皮瓣设计、手术过程及临床疗效进行回顾性分析，结合文献复习对皮瓣特点及手术要点进行讨论和总结。结果 36例患者中，皮肤和软组织缺损位于手背区24例，虎口区、手掌区和拇指区各4例。皮瓣面积最小为4 cm×5 cm，最大为10 cm×14 cm；血管蒂长度3.0~7.5 cm；穿支数量11~15支12例，5~10支20例，1~4支4例；术后36例皮瓣全部成活，成活率100%；术后随访6～12个月，皮瓣血运、弹性、质地良好，患者手部功能恢复满意。结论 前臂背侧骨间动脉穿支逆行岛状皮瓣是修复手部皮肤和软组织缺损的理想供区选择，其穿支出现率稳定、手术可操作性强、皮瓣成活率高，合理的皮瓣设计是手术成功的关键。

关键词: 前臂背侧骨间动脉穿支逆行岛状皮瓣, 皮瓣设计, 皮肤和软组织缺损, 手部

Abstract:

Objective To repair the hand skin and soft tissue defect with the reverse island forearm posterior interosseous flap, observe the outcomes and summarize the characteristics of flap and surgical experience. Methods The clinical data of 36 patients with hand skin and soft tissue defect repaired with the reverse island forearm posterior interosseous flap were collected. The flap location, flap design, surgical procedures and clinical outcomes were retrospectively analysed, and the characteristics of flap and surgical experience were summarized. Results Among the 36 patients, the skin and soft tissue defect involved region dorsalis manus (n=24), first web space (n=4), region volaris manus (n=4) and thumb (n=4). The sizes of flaps ranged from 4 cm×5 cm to 10 cm×14 cm, and the pedicle length ranged from 3.0 cm to 7.5 cm. There were 12 patients with 11 to 15 perforators, 20 patients with 5 to 10 perforators, and 4 patients with 1 to 4 perforators. The flaps were clinically viable in all the 36 patients (100%). Patients were followed up for 6 months to 12 months, and the flaps were similar to skin in texture and elasticity, and had reliable blood supply. All patients had a favorable functional recovery of hands. Conclusion The reverse island forearm posterior interosseous flap has a reliable blood supply, is easy to operate, and can be an ideal donor choice for repair of hand skin and soft tissue defect. The proper flap design may be the key to a successful operation.

Key words: reverse island forearm posterior interosseous flap, flap design, skin and soft tissue defect, hand