The Dorsal Digital Adipofascial Flap for Fingertip Defects-Cases Report and Evolving Thoughts

以同一手指的背側脂肪筋膜皮瓣來重建指尖缺損－病例報告及新構想

周宏璋(Hung-Chang Chou) ； 劉致和(Chin-Ho Liu) ； 呂旭彥(Shiuh-Yen Lu) ； 李鐵國(Tit-Kwork Lee) ； 吳瑞星(Simon Wu)

《中華民國重建整形外科醫學會雜誌》 8卷1期 (1999/03) Pp. 68-77

https://doi.org/10.7096/JPRSA.199903.0068

摘要

自從Gurdin和Pangman 於1950年首先發表交指皮瓣後，就有許多改良型不斷問世。近年來，脂肪筋膜皮瓣因可提供一個血行良好的覆蓋面，已經被廣泛運用在裸露肌腱或骨頭的傷口上。經由交指皮瓣以及脂肪筋膜皮瓣所引發的靈感，我們的新構想乃是尋求一種手術方式能夠合併兩者的優點。我們這次的報告，發表一種手指背側脂肪筋膜皮瓣用來修補指尖的複雜性缺損。這是種一次即可完成的手術，相當容易和安全，而且能夠保留住指頭神經血管的完整，只留下一個美觀的供皮區疤痕。我們遇到了輕微的併發症，是較高的植皮失敗率，可能是因為感染或是植皮下血塊的關係。
這個多樣化的脂肪筋膜皮瓣，由於有相當大旋轉弧度，理論上可以用來修補手指任何的軟組織缺損。對於手指上不大的複雜性傷口，相信可以簡單的用這皮瓣來早期修復。

並列摘要

Since Gurdin and Pangman first described the cross-finger flap in 1950, there have been several modifications reported in the reconstructed hand surgery. Rececntly, the adipofascial turnover flap has been developed to provide a vascularized surface for coverage of the wounds with exposed tendon and/or bone. Conceptually derived from the cross-finger flap and the adipofascial turnover flap, our surgical options evolved to combine the advantages of these flaps. We present a dorsal digital adipofascial flap for the repair of complicated fingertip defects. This is a one-stage procedure and the flap is easy and safe to plan, preserving the digital neurovascular bundles and leaving an aesthetically pleasing donor scar. The minor complication that we experienced is the relatively high skin graft failure rate as a result of infection or subgraft hematoma.
This versatile local flap can also be used for the soft tissue coverage in any location of the fingers due to its large rotation arc. It allows immediate or early closure of difficult small to medium-sized defects of fingers.

並列關鍵字

cross-finger flap ； adipofascial flap ； fingertip reconstruction