拇指尺背侧皮神经营养血管皮瓣修复拇指C形缺损-《中国美容医学》

文章信息/Info

Title:: Repair of C-shaped Defect of Thumb with Dorsoulnar Neurocutaneous Vascular Flap of Thumb?/html>

Author(s):: SHI Ding; LIU Zongyi; RONG Xiangke; SONG Yongbin; MA Rui; Xu Chunjuan; ZHAO Lin; ( Department of Burns and Plastic Surgery, the No. 987 Hospital of PLA Joint Logistic Support Force, Baoji 721004, Shaanxi, China )

摘要:: 目的：探讨拇指尺背侧皮神经营养血管皮瓣修复拇指C形缺损的方法及临床效果。方法：2017年12月-2021年7月，笔者科室采用拇指尺背侧皮神经营养血管皮瓣修复拇指C形缺损患者6例，缺损面积为1.6 cm×2.8 cm～3.5 cm×4.5 cm，缺损范围均大于拇指周径的1/2，不超过3/4，皮瓣切取面积为2.0 cm×3.2 cm～4.0 cm×5.0 cm，供区移植全厚皮片。术后通过电话、微信和门诊随访皮瓣外观、感觉及手功能。结果：术后随访时间为3～26个月，平均9.4个月，所有皮瓣全部存活，供、受区均未发生感染，皮瓣外观良好，两点分辨觉8～22 mm。供区植皮均成活良好，2例供区愈合后遗留线性瘢痕。手指功能：优4例，良1例，可1例。结论：拇指尺背侧皮神经营养血管皮瓣修复拇指C形缺损，手术操作简单，成活率高，不损伤主要血管，术后疗效满意。

Abstract:: Objective To investigate the method and clinical effect of repairing thumb C-shaped defect with dorsoulnar neurocutaneous vascular fl ap of thumb. Methods From December 2017 to July 2021, 6 patients with thumb C-shaped defect were repaired with dorsoulnar neurocutaneous vascular fl ap of thumb,and the wound defect was 1.6 cm×2.8 cm-3.5 cm×4.5 cm, the range of the defect was greater than 1 / 2 of the peripheral diameter of the thumb, not more than 3/4. The cutting area of the fl ap was 2.0 cm×3.2 cm-4.0 cm×5.0 cm, and the donor area was transplanted with a full-thickness skin graft. The appearance, feeling of the flap and hand function were followed up by telephone, wechat/Interenet and outpatient service. Results The follow-up time ranged from 3 to 26 months,with an average of 9.4 months. All fl aps survived without infection in donor and recipient areas. The appearance of the fl ap was good,and the two-point resolution was 8-22 mm. The grafts survived well,and 2 cases left linear scars after donor site healing. Finger function: excellent in 4 cases, good in 1 case and fair in 1 case. Conclusion The repair of C-shaped defect of thumb with dorsoulnar neurocutaneous vascular fl ap of thumb is simple in operation,high in survival rate,does not damage the main blood vessels,and has a satisfactory postoperative eff ect.