桡动脉鼻烟窝穿支蒂前臂皮瓣修复手部软组织缺损

张发惠, 张朝春, 林松庆, 宋一平, 郑和平

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (2) : 223-225.

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (2) : 223-225. DOI: 10.13418/j.issn.1001-165x.2015
临床研究

桡动脉鼻烟窝穿支蒂前臂皮瓣修复手部软组织缺损

  • 张发惠1 ,   张朝春1,   林松庆1,   宋一平2,   郑和平 
作者信息 +

Reconstruction of defects on the hand with flaps based on the perforator located at the snuff box

  • ZHANG Fa-hui 1,  ZHANG Chao-chun 1,   Lin Son-qing 1,   SON Yi-ping 2,   ZHENG He-ping1
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摘要

目的 探讨桡动脉鼻烟窝穿支前臂外侧皮-头静脉神经营养血管远端蒂皮瓣临床应用效果。方法   在前臂远端动脉穿支解剖学研究的基础上,2005年3月至2013年3月间临床采用虎口动脉穿支蒂前臂皮瓣修复手部创伤性软组织缺损27例,致伤原因:机器致伤15例,车祸致伤8例,爆炸伤4例。缺损部位:手背软组织缺损13例;手掌软组织缺损3例;虎口区挛缩11例。软组织缺损面积5.0 cm×3.0 cm~12.0 cm×4.0 cm。皮瓣切取面积:最小为6.0 cm×4.0 cm,最大为14.0 cm×6.0 cm,皮瓣旋转点平桡腕关节。  结果    临床修复27例,创面Ⅰ期愈合26例,Ⅱ期愈合1例。所有病例经2~12个月随访,皮瓣色泽正常,手外形与功能改善满意,前臂供区创面植皮愈合良好,对功能无不良影响。  结论   桡动脉鼻烟窝穿支蒂前臂皮瓣,可以修复手部远侧创面,效果好。

Abstract

Objective   The aim of this study is to investigate the clinical results of flaps based on the perforator located at the snuff box to cover soft tissue defects on the hand.   Methods   Between March 2005 and March 2013, based on the anatomic study of distal arterial perforators of forearm, 27 patients with soft-tissue defects on the hand underwent reconstruction with the flaps based on the perforator located at the snuff box The etiology of injury: 15 cases were caused by  machines, eight by traffic accident, 4 by explosion. The defect location was as follows: 13 at the dorsal hand, 3 at the palm, 11 at the first web. The defect size ranged from 5.0 cm×3.0 cm to 12.0 cm×4.0 cm. The smallest dimension of the flaps was 6.0 cm×4.0 cm and the largest 14.0 cm×6.0 cm. The rotation point was at the wrist joint level.  Results   26 cases of total 27 clinical application cases achieved primary healing; only one case obtained secondary healing. Postoperative following-up of the patients ranged from 2 to 12 months. all flaps survived completely with good color and the appearance and function were  satisfactory. The donor site healed without morbidity after reconstruction with skin-grafting.   Conclusion   tThe flap based on the perforator located at the snuff box  is an ideal flap for repairing soft tissue defects of distal segment of hands.

关键词

前臂外侧皮神经 / 头静脉 / 桡动脉鼻烟窝穿支 / 远端蒂皮瓣

Key words

Lateral cutaneous nerve of forearm / Cephalic vein / the first web artery perforator / Distal based perforator flap

引用本文

导出引用
张发惠, 张朝春, 林松庆, 宋一平, 郑和平. 桡动脉鼻烟窝穿支蒂前臂皮瓣修复手部软组织缺损[J]. 中国临床解剖学杂志. 2015, 33(2): 223-225 https://doi.org/10.13418/j.issn.1001-165x.2015
ZHANG Fa-Hui, ZHANG Chao-Chun, LIN Song-Qiang, SONG Yi-Beng, ZHENG He-Beng. Reconstruction of defects on the hand with flaps based on the perforator located at the snuff box[J]. Chinese Journal of Clinical Anatomy. 2015, 33(2): 223-225 https://doi.org/10.13418/j.issn.1001-165x.2015
中图分类号: R323.71    R616.2   

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基金

福建省自然科学基金(C0510034)


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