摘要目的 报道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的临床疗效. 方法 自2011年1月至2015年1月,应用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60指.其中示指30指,中指15指,环指10指,小指5指.切取皮瓣面积1.2cm×1.7cm～3.2cm×3.6cm,皮瓣内携带指同有神经背侧支与创面指神经断端进行显微修复,重建皮肤的感觉.供区取腕部或上臂内侧远端全厚植皮.采用英国医学研究会对感觉评定标准对感觉恢复进行评定. 结果 本组60例60指,皮瓣全部成活.12指皮瓣出现张力性水泡,经拆线后,皮瓣顺利成活.随访根据中华医学会手外科学会上肢部分功能评定试用标准TAM法评定:优50指,良10指,优良率100％;48指皮瓣感觉恢复至S4级,12指恢复至S3级;两点辨别觉5～8mm,平均6.5 mm;患者远、近指间关节平均活动度恢复优良.皮瓣肤色红润,质地柔软,无臃肿,无色素沉着,无畏寒表现,无瘢痕增生及挛缩,皮肤痛觉无过敏及再次手术. 结论 此皮瓣对于手指远端皮肤缺损修复是一种简单易行、不损伤主要动脉及神经、感觉恢复良好、术后并发症少、皮瓣成活优良的方法,值得基层医院推广.

abstractsObjective To explore the clinical effect of dorsal digital artery reverse island flap in the repair of distal finger skin defect.Methods From January,2011 to January,2015,60 fingers of 60 cases with dorsal branch of the digital artery were used to repair the defect of the distal finger skin.The 30 refers to the index finger,middle finger 15 fingers,10 ring fingers and 5 little fingers.Harvested area of 1.2 cm ×1.7 cm to 3.2 cm × 3.6 cm,the wrist or distal medial arm full thickness skin graft donor site.Evaluation of sensory recovery by the British Medical Research Association.Results All flaps survived.Twelve finger flap tension blisters,and the flaps survived after the stitches.Follow-up of 60 cases of 60 to hand function according to the Chinese medicine will hand surgery society of upper extremity function evaluation standard trial Tam method to evaluate the:50 excellent,10 fingers good,the excellent and good rate was 100％;48 fingers flap sensation recovery to S4 class,and 12 refers to the recovery to S3.The two-point discrimination perception of 5 to 8 mm,average 6.5 mm;patients far,nearly interphalangeal joint average activity recovery was good.Skin flap skin ruddy,soft texture,no fat,no pigmentation,fearless cold performance.No scar hypertrophy and contracture,skin pain no allergy and reoperation.Conclusion The flap for repair of distal finger skin defect is a simple,no damage to the main artery and nerve and good sensory recovery,less postoperative complications,and excellent method of flap survival.It is worth promotion in primary hospitals.