摘要目的 探讨采用足背并联皮瓣修复手掌贯穿性皮肤软组织缺损的疗效. 方法 2008年7月-2010年11月,笔者单位收治18例手掌贯穿性皮肤软组织缺损患者.单处皮肤软组织缺损面积为2.0 cm×l.5 cm～5.0 cm ×2.5 cm.应用足背并联皮瓣治疗,单处皮瓣切取面积为2.0 cm×2.0 cm～5.5 cm ×3.0 cm.供瓣区创面采用自体大腿内侧全厚皮片修复. 结果 术后18例患者皮瓣全部成活,所有足部供区植皮均成活.本组17例患者术后随访6～23个月,平均10个月;l例患者失访.17例皮瓣外观恢复较好,皮瓣质地柔软、弹性好,无臃肿,未见明显色素沉着以及瘢痕挛缩.行神经吻合的13例患者,末次随访时皮瓣两点辨别觉距离为6.0 ～9.0 mm,平均7.4 mm,感觉功能评定达到S3级. 结论 足背并联皮瓣血运可靠、设计灵活,是修复手掌贯穿性皮肤软组织缺损的较佳选择.

abstractsObjective To explore the effect of dorsalis pedis parallel flaps in repairing perforating skin and soft tissue defects of the palms.Methods Eighteen patients with perforating skin and soft tissue defects of the palms were hospitalized from July 2008 to November 2010.The area of skin defect ranged from 2.0 cm × 1.5 cm to 5.0 cm ×2.5 cm.The dorsalis pedis parallel flaps were used to repair these defects,with the area ranging from 2.0 cm × 2.0 cm to 5.5 cm × 3.0 cm.The donor sites were covered with autologous full-thickness skin from inner thigh.Results All the 18 flaps and skin grafts of donor sites survived completely.Seventeen patients were followed up for 6 to 23 months,with mean time of 10 months,and one patient was lost to follow-up.The texture,elasticity,and appearance of all the 17 flaps were satisfactory,with no obvious pigmentation or cicatricial contracture.At the last follow-up,the distance of two-point discrimination of flaps ranged from 6 to 9 mm,with mean distance of 7.4 mm,and the sensation of flaps reached S3 in 13 patients who had nerve anastomosis.Conclusions The dorsalis pedis parallel flap,with reliable blood supply and flexible design,is a good choice for repairing perforating skin and soft tissue defects of the palms.