Chinese Journal of Clinical Anatomy >
Reconstruction of defects on the hand with flaps based on the perforator located at the snuff box
Received date: 2014-04-29
Online published: 2015-04-21
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．
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 . DOI: 10.13418/j.issn.1001-165x.2015
[1] Masquelet Ac，Romana MC ,Wolf G. Skin island flaps supplied by the vascular axis of the sensitive superficial nerve:anatomic study and clinical experience in the leg
[J]. Plast Reconstr Surg, 1992, 89(6):1115-1121.
[2] Bertelli JA, Khoury Z. Neurocutaneous island flap in the hand: anatomical basis and preliminary result
[J].Br J Plast Surg,1992,45(8):586-590.
[3] 傅小宽, 王琰, 庄永青, 等.手与前臂皮神经伴行血管逆行岛状皮瓣的临床应用
[J].中华显微外科杂志,1997,20(3):192-194.
[4] 罗少军,王绥江,汤少明,等.前臂外侧皮神经营养血管远端蒂筋膜皮的解剖和临床应用
[J].中华显微外科杂志,1999,22(4):283-284.
[5] 黄群武,廖进民,谢华,等.带前臂外侧皮神经营养血管筋膜皮瓣的应用解剖［J］.中华显微外科杂志,1998,21(4):276-279.
[6] 柴益民,吕国坤,陈彦跍,等.带前臂皮神经营养血管蒂岛状皮瓣的临床应用
[J].中华显微外科杂志,1998,21（1）:15-18.
[7] 芮永军,徐建光,顾玉东.以前臂皮神经及其营养血管为蒂的岛状皮瓣解剖学研究［J］.中国临床解剖学杂志,1999,17(1):7-9.
[8] 王绥江, 罗少军, 吕端远, 等.前臂内侧皮神经的供血特点及其在皮瓣设计中意义［J］.中华显微外科杂志, 2000, 23(3):210-212.
[9] 柴益民, 林正崇, 陈彦, 等.骨间前血管前臂背侧皮神经营养血管皮瓣的临床应用
[J].中华显微外科杂志,2002,25(4):247-248.
[10]Bertelli JA, Kaleli T. Retrograde-flow neurocutaneous island flaps in the forearm: anantomic basis and clinical results
[J].Plast reconstr Surg,1995,95:851-856.
[11]张高孟，顾玉东， 张丽银，等. 桡动脉鼻烟窝筋膜穿支皮瓣
[J]. 手外科杂志，1992，8（2）：67-68.
[12]Zhang FH, Topp SG., Zhang WJ, et al. Anatomic study of distally based pedicle compound flaps with nutrient vessels of the cutaneous nerves and superficial veins of the forearm
[J]. Microsurgery, 2006, 26(5): 373-385.
[13]张发惠,郑和平,张国栋,等. 前臂桡侧头静脉-皮神经营养血管的解剖学研究
[J].解剖学杂志, 2006, 29(1):101-104.
[14]张发惠, 郑和平.上肢皮神经—浅静脉营养血管远端蒂复合瓣的解剖学基础
[J]. 解剖与临床, 2006,12 (1):3-6.
[15]黄飞, 张发惠, 吴水培. 前臂皮神经--浅静脉营养血管远端蒂皮瓣的显微解剖临床应用
[J]. 解剖与临床，2006, 11(1):6-9.
[16] Nakajima H, Imanishi N, Fukuzumi S, et al. Accompanying arteries of the cutaneous veins and cutaneous nerves in the extremities: anatomical study and a concept of the venoadipofascial and/ of neuroadipofascial pedicled fasciocutaneous flap
[J].Plast Reconstr Surg, 1998,102(3):779-791.
[17]Taylor GI, Caddy CM, Watterson PA, et al.The venous territories of the human body:experimental study and clinical implications
[J]. Plast Reconstr Sury, 1990, 86(2):185-213.
[18]Bertelli JA, Khoury Z. Neurocutaneous axial island flap in the forearm: anatomical experimental, and preliminary clinical result
[J].Br J Plast Surg,1 993, 46(6):489-493.
/
| 〈 |
|
〉 |
