| 指动脉双叶皮瓣修复拇指皮肤套状缺损 |
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投稿时间：2013-12-05
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| 作者 | Author | 单位 | Address | E-Mail |
| 张扬 |
ZHANG Yang |
沈阳医学院奉天医院手外二科, 辽宁 沈阳 110024 |
Department of Hand Surgery, Fengtian Hospital Affiliated to Shenyang Medical College, Shenyang 110024, Liaoning, China |
paulzhang_1979@hotmail.com |
| 辛畅泰 |
XIN Chang-tai |
沈阳医学院奉天医院手外二科, 辽宁 沈阳 110024 |
Department of Hand Surgery, Fengtian Hospital Affiliated to Shenyang Medical College, Shenyang 110024, Liaoning, China |
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| 期刊信息：《中国骨伤》2014年，第27卷，第4期，第307-310页 |
| DOI：10.3969/j.issn.1003-0034.2014.04.011 |
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中文摘要:
目的：探讨应用指动脉双叶皮瓣修复拇指套状缺损的可行性。
方法：自2007年1月至2012年12月，对45例拇指套状缺损患者采用指动脉双叶皮瓣修复治疗。男39例，女6例；年龄19～46岁，平均32岁。平甲根平面的掌侧皮肤和甲床缺损18例，拇指末节皮肤套脱19例，整个拇指皮肤套脱8例。根据拇指皮肤缺损情况，分别于中指尺侧和环指桡侧设计皮瓣的2个叶，以中环间的指总动脉及其向中指及环指的2个指固有动脉为血管蒂，皮瓣携带指固有神经，将皮瓣转位后瓦合覆盖拇指外露指骨。皮瓣供区用全层皮片植皮，观察皮瓣的外观、质地、颜色和耐磨性，植皮区外观、颜色和凹陷，皮瓣的感觉，手指活动等。
结果：所有患者皮瓣及植皮区组织全部成活，完成随访43例，平均随访25个月。失访2例，皮瓣色泽及质地与健侧拇指指腹相近，两点辨别觉平均（4.2±0.3） mm.植皮区，皮肤颜色略深于周围皮肤。
结论：应用指动脉双叶皮瓣修复拇指套状缺损是风险小、成功率高、修复效果较理想的手术方式。 |
| 【关键词】指动脉 皮瓣 拇指 创作和损伤 |
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| Digital artery bilobed flap for the treatment of skin degloving injury of thumb |
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ABSTRACT
Objective: To explore clinical effects of digital artery bilobed flap for the treatment of skin degloving injury of thumb.
Methods: From January 2007 to December 2012,45 patients with skin degloving injury of thumb were treated with grafting of digital artery bilobed flap. There were 39 males and 6 females,ranging in age from 19 to 46 years,with an average of 32 years. The disease course ranged from 0.5 to 15 h. Eighteen patients suffered from defect of palmar skin above nail root and nail bed,19 patients suffered from skin degloving injury of thumb phalangette,and 8 patients had whole skin degloving injury of thumb. The double lobe flaps were designed at the ulnar side of middle finger and the radial side of ring finger according to the defect of thumb skin. The arteria digitalis communis between the middle and ring fingers and its two branches of arteriae digitales propriae supplying the two fingers were used as a vesselpedicle. The flap with digitales proprii nervi was transposed and used to cover the exposed phalanx of thumb. Full thickness graft was used for the donor site. Observation of the appearance,texture,color and wear resistance of flap,appearance,color and depression of grafting area,skin feeling,and finger activities was conducted.
Results: All the flaps and grafts were alive. Forty-three patients were followed up with an average duration of 25 months,and two patients lost follow-up. The color and texture of the flaps were similar to that of the contralateral thumb pulp. The average two point discrimination was 4.2±0.3 mm. The color of graft skin was slightly deeper than that of the surroundings skin.
Conclusion: Digital artery bilobed flap graft is an effective and ideal operation,which is of low risk and high success rates for skin degloving injury of thumb. |
| KEY WORDS Digital artery Flap Thumb Wounds and injuries |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张扬,辛畅泰.指动脉双叶皮瓣修复拇指皮肤套状缺损[J].中国骨伤,2014,27(4):307~310 |
| 英文格式: | ZHANG Yang,XIN Chang-tai.Digital artery bilobed flap for the treatment of skin degloving injury of thumb[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(4):307~310 |
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