Clinical Application Study Of 4 Kinds Of Digital Artery Flaps Based On Anatomical Research

Chapter One Anatomical study of digital arteries and dorsal cutaneous branchObjective:Through the anatomical study of the finger arteries and the dorsal branch of the finger,the position,shape,quantity and distribution of the dorsal branch of the finger artery were understood,and the measurem ent and recording were performed.Capillary network.It provides an anatomical basis for the design of skin branch flap and skin branch chain flap in repairing finger soft tissue defects in clinic.Method:Take 10 pairs of 20 fresh hand specimens,and infuse the red filler into the radial artery of the forearm.After the coagulation,the anatomy and all the cutaneous branches of the finger arteries and dorsal digits are dissected to find out.The diameter of the branch was measured,the position of the starting point of the dorsal dermal branch was recorded,and the distribution of the shape and the network connection at the back of the finger were observed.The anatomy shows the origin,shape,and position of the blood vessels of the dorsal metacarpal branch of the radial finger arteries.Learn about the composition and source of the skin supplying blood vessels at the dorsal muscle of the first interosseous dorsum of the hand.Results:There are 4 thicker skin branches in the finger arteries at the constant position of the proximal and middle segments of the fingers.In addition to these skin branches,the finger arteries also emit a number of capillary branches in the direction of the dorsal finger that can be recognized by the naked eye.The positions of these capillaries are variable,the thickness varies,and the spacing is not constant(less than 0.5 cm).The dorsal cutaneous branch of the digital arteries issues multiple secondary branches,forming capillary chains on the sides and back of the fingers.The blood supply of the radial skin on the dorsal side of the palm mainly includes:the percutaneous branch from the first dorsal metacarpal artery;the dorsal branch of the palm from the major artery of the thumb;the dorsal metacarpal branch of the radial finger;Wear branch.Among them,the dorsal palmar cutaneous branch of the index finger radial finger artery is the dominant blood vessel.Conclusion:There is a rich network of capillaries in the skin of the dorsal interosseous muscle of the back of the fingers and the back of the palm.The main feeding arteries are all from the dorsal cutaneous branch of the finger arteries.Based on this anatomic basis,dorsal and dorsum palmar radial skin flaps can be designed to repair soft tissue defects of fingers.Chapter two:Clinical application of finger skin branch flap and skin branch chain flapObjective:Based on the anatomical study of the digital arterial system,skin branch flaps and skin branch chain flaps were designed at the dorsal,interphalangeal and dorsal interosseous muscles of the back of the palm to repair finger soft tissue defects and explore its clinical efficacy.Method:A total of 33 patients with finger soft tissue defects were clinically selected,and 4 kinds of skin flaps were designed to repair them.Regular follow-up was performed after surgery,and the surgical effects were evaluated according to multiple evaluation indicators.Results:In 33 cases of soft tissue defects of the fingers,the flaps survived.In 4 cases,the 4-finger flaps had poor local blood flow.After suture removal and dressing change,the flaps’ blood flow improved.The follow-up period ranged from 6 months to 2 years,with an average follow-up of 13.5 months.The appearance of the flap was good,no obvious pigmentation was found,the sensory part recovered,the flexion and extension of the injured finger was good,and the patient satisfaction was high.Conclusion:Based on the anatomical study of the digital arteries and the dorsal cutaneous branch of the finger,a cutaneous branch flap or dermatome branch flap based on the position of the wound surface of the finger can be used to effectively cover the wound surface of the finger.This series of flaps has the advantages of beautiful appearance of the flaps,small side injuries,and small impact on finger movements,simple operation,low risk,and is suitable for popularization.