Objective To repair the dorsal wound by increasing the propulsion distance of the dorsal flap through the multi-grade effect of the ductility of the skin, the slip between the subcutaneous superficial fascia and the skin, the angular displacement of the dorsal branch from the proper digital artery and the elasticity of the proper digital artery. Methods The skin flaps of 34 fingers on 11 sides of fresh adult cadaveric hands were designed on the dorsal side of the middle and proximal segments of the finger respectively. The contents of the flap included the dorsal skin, the subcutaneous superficial fascia, the proper digital artery on one side of the finger and the dorsal branch of the proper digital artery. When the flap was pushed to the distal end of the finger, the ductility of the skin，the sliding of the subcutaneous superficial fascia,the angular displacement of the dorsal branch of the proper digital artery and the elasticity of the proper digital artery all played a certain role in the advancement of the dorsal finger flap respectively, the advancement distance of the flap can be increased by the multi-grade superposition of these four effects. Results The maximum propulsion distance of the dorsal flap simulated on the fresh specimens was 2.4 cm and the dorsal flap in the proximal segment of finger was 4.5 cm. Conclusions The advancing distance of the dorsal multi-grade advanced flap increases significantly. The maximum advancing distance is 4.5cm and the average distance is 2.5cm. The operation of the multistage advancing dorsal finger flap is safe and simple, it is one of the ideal flap for repairing small and medium-sized wounds of the dorsal finger.
Key words
Dorsal finger skin defect /
Repair /
/
/
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Proper digital artery /
Advancement flap
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References
[1] 任志勇,魏长月,黄东平,等.手指背侧组织缺损修复与重建方法的选择[J]. 中华显微外科杂志, 2004, 27(2):143-144.DOI:10.3760/cma.j.issn. 1001-2036.2004.02.027.
[2] 侯桥,曾林如,王利祥,等.V-Y推进皮瓣蒂部植皮修复指尖缺损[J].中华手外科杂志, 2012, 28(3):134-135.DOI:10.3760/cma.j.issn.1005-054X. 2012.03.00.
[3] 王云锋,杨敏,张文正,等.指背V-Y推进皮瓣修复手指近节侧方岛状皮瓣供区32例[J].中华显微外科杂志, 2018, 41(3):275-277. DOI:10.3760/cma.j.issn.1001-2036.2018.02.021.
[4] 唐林峰，巨积辉，蒋国栋，等. 指背神经筋膜蒂皮瓣供区应用掌指背V-Y推进皮瓣修复的研究[J]. 中华手外科杂志, 2015, 31(2):126-128.DOI:10.3760/cma.j.issn.1005-054X.2015.02.019.
[5] 吴泽勇.改良V-Y推进皮瓣在手指软组织缺损中的应用[J].中华手外科杂志, 2014, 30(4):289-291. DOI:10.3760/cma.j.issn.1005-054X. 2014. 04. 020.
[6] 刘宗义, 王从虎, 席志峰,等.带指动脉神经蒂的V-Y推进皮瓣修复指端缺损[J].实用手外科杂志, 2012, 26(1):48-49.DOI:10.3969/j.issn.1671-2722.2012.01.030.
[7] 周晓,芮永军,许亚军,等.指动脉不同节段背侧皮支为蒂的V-Y推进皮瓣修复同指指背皮肤缺损[J].中国修复重建外科杂志, 2011, 25(1):104-106.DIO:CNKI:51-1372/R_20101210.1518.059.
[8] 王云锋,张春风,杨敏,等.指背V-Y推进皮瓣修复多指近节岛状皮瓣供区[J]. 中华手外科杂志, 2017, 33(4):243-244.DOI:10.3760/cma.j.issn.1005-054X.2017.04.002.
[9] Chen C, Tang P, Zhang L, et al. Repair of multiple finger defects using the dorsal homodigital island flaps[J]. Injury-international Journal of the Care of the Injured, 2013, 44(11):1582-1588. DOI:10.1016/j.injury. 2013. 05. 019.
[10]Kawakatsu M, Ishikawa K. Dorsal digital perforator flap for reconstruction of distal dorsal finger defects[J]. Journal of Plastic Reconstructive & Aesthetic Surgery, 2010, 63(1).e46-e50.DOI:10.1055/s-0030-1268852.
[11]Deal DN, Barnwell J, Li ZY. Soft-tissue coverage of complex dorsal hand and finger defects using the turnover adipofascial flap.[J]. J Reconstr Microsurgery, 2011,27(2):133-138. DOI: 10.1055/s-0030-1268852.
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