Free Ipsilateral-Pedicled Arterialized Venous Flaps for Reconstruction of Finger Defects

以根蒂同側型游離動脈化靜脈皮瓣重建手指的組織缺失

方嘉良(Chia-Liang Fang) ； 楊振(Chen Yang) ； 李宗翰(Tzong-Hann Lee)

《中華民國整形外科醫學會雜誌》 10卷4期 (2001/12) Pp. 240-246

https://doi.org/10.7096/JPSA.200112.0240

摘要

我們報告六例採用根蒂用同側型的游離動脈化靜脈皮瓣，來重建手部的組織缺失。手術過程和傳統的游離動脈化靜脈皮瓣相似，不同點在於靜脈根蒂方向為同側非反向。我們的根蒂同側型游離動脈化靜脈皮瓣取自手指近端指節背側的皮膚，它的優點，包括皮膚內有豐富的靜脈網結構，又血管根蒂同方向，使與收受區的血管吻合時，較容易評估和安置兩端血管的方向及不同管徑血管的選擇。病患六例中五例完全存活，一例因淺層表皮壞死，但真皮層仍存活，待兩周後才自然癒合。

並列摘要

Free arterialized flaps of an ipsilateral-pedicled pattern, similar to the standard free venous flap, were used in six patients to repair hand defects instead of using a contralateral-pedicled type of flap. It encompassed the afferent and efferent pathways locating in the same direction in contrast to the conventional type containing the pathways in different sides. The ipsilateral-pedicled venous flap taking from the dorsal aspect of the proximal phalanx has several advantages while comparing wiht the conventional contralateral-pedicled one, including its rich venous network, easier assessment and arrangement of the different diameter of the anastomotic vessels, less invasive for both the injured finger and donor site, and radial nerve included in the pedicle if a sensory reconstruction needed. Five flaps survived completely. One case developed superficial necrosis but a viable dermal layer remained and delayed healing occurred over two weeks.

並列關鍵字

finger defect ； arterialized free venous flap