摘要目的 报告双干型静脉皮瓣在撕脱性断指再植中的应用和临床效果.方法 2007年3月至2009年6月,采用前臂双干型静脉皮瓣游离移植修复伴有皮肤软组织缺损的撕脱性断指6例,损伤至入院时间为30 min至8 h,切取皮瓣面积为1.8cm×1.8cm～2.2 cm×5.8cm,供区创面直接缝合.结果 术后6例伤口均Ⅰ期愈合,断指再植全部存活;5例静脉皮瓣无肿胀,顺利存活;1例皮瓣早期肿胀明显,紫红色,并见散在小水泡,经拆除部分缝线、换药等对症处理后顺利存活.术后随访时间为6个月至2年.皮瓣及再植手指血运好,皮瓣质地软,弹性好、耐磨.根据中华医学会手外科学会断指再植功能评定试用标准评定;优4例,良1例,可1例;优良率为82.5%.结论 采用前臂掌侧双干型静脉皮瓣游离移植修复伴有皮肤软组织缺损的撕脱性断指,能最大程度地恢复手指的功能和外形.

abstractsObjective To report the application and results of venous flap with double vein trunks in replantation of degloved fingers.Methods From March 2007 to June 2009, 6 cases of soft tissue defect in the degloved finger were replanted with venous flap with double vein trunks.The interval between injury and operation was 30 minutes to 8 hours.All fingers were replanted by arterialized free venous flap from the ipsilateral forearm with double vein trunks.The flap was 1.8 cm×1.8 cm to 2.2 cm× 5.8 cm in size.The donor site was directly closed.Results Primary wound healing was observed in all 6 cases postoperatively.All the replanted fingers survived completely.In 5 cases the venous flaps survived uneventfully.In 1 case there was partial superficial necrosis of the flap which healed with conservative management.Postoperative follow-up ranged from 6 to 24 months.The flaps and fingers had good circulation, good texture and color match.According to the criteria for functional assessment of amputated finger issued by the Chinese Hand Surgery Society, the results were graded as excellent in4cases, goodin 1 case, andfairin 1 case.Theoverall excellent rate was 82.5%.Conclusion Replantation of degloved finger with fransfer of venous flap with double vein trunks is capable of repairing pulp soft tissue defect and maximizing the restoration of finger appearance and function.