Abstract:【Objective】To investigate the clinical effect of reconstruction sensory of reverse dorsal digital island flap of fingertip defects.【Methods】A total of 70 patients with 78 fingertip defects in our hospital from January 2015 to December 2016 were collected in the study. All patients underwent reconstruction sensory of reverse dorsal digital island flap and anastomosis of nerve branch and intrinsic nerve stump.【Results】In this study, skin blisters occurred in 5 cases of 7 fingers 3d after operation and healed after symptomatic treatment. The remaining flaps successfully survived and wounds healed very well. The rate of superficial sensory recovery at 6 months after operation was 100.00%, which was significantly higher than 76.92% and 0.00% at 3 months and 1 month after operation (P<0.05). All patients recovered from deep pain at one month after operation. At 6 months after operation, the two-point discrimination was (5.48±1.14) mm, which was significantly less than that of the postoperative 3 months (P<0.05). The sensory recovery of the flap at 6 months postoperatively was significantly better than that at 1 and 3 months postoperatively and the ratio of S4 reached 61.54% (48/78).【Conclusion】Reconstruction sensory of reverse dorsal digital island flap of fingertip defects is an effective method to restore the skin flap.
章飞翔,吕书军,曹毅. 经重建感觉的指动脉终末背侧支逆行岛状皮瓣修复指端缺损的疗效观察[J]. 医学临床研究, 2018, 35(1): 49-51.
ZHANG Fei-xiang. Clinical Observation of Reverse Island Flap of Dorsal Branch of Digital Artery in Reconstruction of Fingertip Defect. JOURNAL OF CLINICAL RESEARCH, 2018, 35(1): 49-51.
[1] 郑晓东,黄辉强,陈锦涛,等.指掌侧固有动脉背侧支逆行岛状皮瓣修复手指远端皮肤缺损60例[J].中华显微外科杂志,2016,39(4):333-336. [2] 王振继.断指再植术后静脉皮瓣桥接修复的临床应用价值[J].医学临床研究,2016,33(11):2173-2175. [3] 邓国超,宋维海,闫鹏,等.第一掌骨桡背侧动脉皮支链带筋膜蒂岛状皮瓣修复拇指组织缺损35例[J].中华显微外科杂志,2015,38(5):484-486. [4] Chen C,Tang P,Zhang X.A comparison of the dorsal digital island flap with the dorsal branch of the digital nerve versus the dorsal digital nerve for fingertip and finger pulp reconstruction [J].Plast Recons Surg,2014,133(2):165e. [5] 冯仕明,王爱国,张在轶,等.携带指固有神经背侧支的指动脉顺行岛状皮瓣修复指端皮肤缺损[J].中华手外科杂志,2014,30(6):476-477. [6] 丁振平,董杰,陆洋.不同逆行岛状皮瓣修复方案在拇指创伤中的疗效比较[J].医学临床研究,2017,34(2):226-228. [7] 陈乐锋,张振伟,游楚红,等.中指近节桡侧指动脉邻指逆行岛状皮瓣修复拇指指端缺损[J].中华手外科杂志,2014,30(1):44-46. [8] Chen C,Tang P,Zhao G.Direct and reversed dorsal digital island flaps: A review of 65 cases[J].Injury,2014,45(12):2013-2017. [9] 史增元,尹维刚,俞淼,等.拇指尺侧指背动脉为蒂的虎口背侧逆行岛状皮瓣的解剖与临床应用[J].中华显微外科杂志,2014,37(1):63-66. [10] 卜凡玉,薛明宇,芮永军,等.改良前臂骨间背侧动脉逆行岛状皮瓣修复手背部皮肤缺损疗效观察[J].中国修复重建外科杂志,2014,26(2):237-240. [11] 冯仕明,丁朋,王爱国,等.改良指掌侧固有动脉岛状皮瓣修复烧伤后指屈曲挛缩畸形[J].中华显微外科杂志,2016,39(5):445-448. [12] 杨亚南,陈祥军,刘宁,等.骨间背侧动脉岛状皮瓣修复手部软组织缺损[J].中华创伤杂志,2015,31(9):842-844. [13] Regmi S,Gu JX,Zhang NC,et al.A systematic review of outcomes and complications of primary fingertip reconstruction using reverse-flow homodigital island flaps [J].Aesthetic Plast Surg,2016,40(2):1-7. [14] 李启朝,边朝辉,朱伟,等.长蒂邻指指固有动脉背侧支岛状皮瓣修复手指中末节侧方组织缺损[J].中华手外科杂志,2015,31(5):340-342. [15] 魏鹏,陈薇薇,沈华军,等.指固有血管神经束背侧支顺行岛状皮瓣修复指端缺损[J].中华显微外科杂志,2014,37(5):464-467.