目的　分析手部不同远端蒂皮瓣修复手部皮肤缺损静脉回流障碍的原因及改善静脉回流的方法。  方法    对56例手部皮肤缺损的患者应用远端蒂拇指指背皮神经营养血管皮瓣、逆行掌背动脉皮瓣、远端蒂尺神经手背支营养血管皮瓣等不同方法分别进行修复。  结果    本组53例皮瓣全部成活，早期有3例远端蒂拇指指背皮神经营养血管皮瓣转移后出现边缘坏死，经换药后愈合。   结论    远端蒂皮瓣蒂部的处理是皮瓣成活的关键，在皮瓣蒂部结扎浅静脉干能够有效地降低皮瓣转位术后静脉危象的发生率，改善静脉回流。

Objective　To investigate the causes of the venous drainage problem of different pedicled flaps adopted for resurfacing of the defects in the hand as well as the methods to improve the condition. Methods　56 patients various kinds of hand skin defects were treated with flaps pedicled on the nutrient vessels of the distal thumb dorsal cutaneous nerve,the retrograde dorsal metacarpal flaps and flaps based on the nutirent vessels of the dorsal branch of the hand according to the type of the defect.    Results    Falps in all cases survived. 3 cases treated with flaps pedicled on the nutrient vessels of the distal thumb dorsal cutaneous nerve suffer marginal necrosis in early stage, which was cured by dressings change.  Conclusions    The treatment of the pedicle is the key to the surival of different pedicled flaps. Superficial vein ligation of pedicle flaps can effectively reduce the incidence of venous crisis after flap transplantation.