摘要目的 探讨吻合浅静脉的指背神经筋膜蒂皮瓣修复指端缺损的临床疗效.方法 自2016年1月至2017年2月,我们对25例25指指端缺损患者采用近节指背神经筋膜蒂皮瓣修复创面,术中保留皮瓣近端的一条浅静脉断端,皮瓣转移至创面后将该浅静脉断端与指端皮下静脉断端吻合,重建皮瓣静脉循环.结果 本组25例25指皮瓣均存活,术后2周内皮瓣外观良好,无水泡及皮色青紫.术后随访时间为6～8个月,平均6.5个月,皮瓣外观良好,无明显臃肿,质地柔软,部分皮瓣色素沉着,皮瓣痛温觉均恢复,手指各关节活动良好.所有指背植皮成活.结论 吻合浅静脉的指背神经筋膜蒂皮瓣修复指端缺损克服了传统的指背神经筋膜蒂皮瓣回流不佳的缺点,皮瓣存活得到有效保证.

abstractsObjective To investigate the clinical efficacy of dorsal digital nerves fasciocutaneous flap with superficial vein anastomosis in the treatment of fingertip defects.Methods From January 2016 to February 2017,25 cases (25 fingers) of fingertip defects were treated with proximal dorsal digital nerve fasciocutaneous flap.After the flap was transferred to cover the wound,the stump of a superficial vein retained at the proximal end of the flap was anastomosed to the stump of fingertip subcutaneous vein for reconstruction of flap venous circulation.Results All the flaps survived uneventfully.The appearance of flaps was good without blisters and purple skin 2 weeks after operation.The postoperative follow-up time ranged from 6 to 8 months with an average of 6.5 months.The flap had good appearance,no obvious bulky shape and soft texture.Some flaps had pigmentation.The skin pain and temperature sensation were restored.The joints of the fingers were in good motion.All the skin grafts survived.Conclusion The dorsal digital nerve fasciocutaneous flap with superficial vein anastomosis for repair of fingertip defects overcomes the shortcomings of the traditional flap with poor backflow,and the survival of the flap is effectively guaranteed.