Repair Of Skin Defects Of The Fingers Blood Vessels Defects By Island Skin Flaps From The Nearby Fingers

Objective: To explore the produce and treatment effect of repair of skin defects of the fingers with digital artery defects by island skin flaps from nearby fingers.Methods :From June 2005 to May 2015, twenty-three patients with skin and digital artery defects of the finger palm side were bridge repaired by island skin flaps from nearby fingers. Aged from 15 to 58, averaging 38 years, Causes of injury: 6 cases of hot crush injury, 6 cases of stamping injury, grinding machines run in 9 cases, 2 cases of injury of gear. Damage location: The injury index finger in 6 cases,3 cases in the proximal; middle finger in 5 cases,2 cases of proximal phalanx; ring finger proximal section in 2 cases, 2 cases in the proximal; 3 cases of proximal phalanx of little finger. Wounds were associated with tendon or bone exposure, of which 5 cases accompanied with bone fracture, 7 cases associated with tendon rupture, 4 cases accompanied by a phalanx fractures and tendon rupture and distal finger blood circulation disorder. 4 cases accompanied by bilateral nerve defect, 14 cases associated with unilateral nerve defect. In addition, the wound area is about 1.2cm x 1.3cm ~ 2.0cm x 2.6cm, vascular defect length is 1.5 cm to 3.0 cm in diameter.The area of flaps ranged from 1.5cm×1.5cm to 2.2cm×3.0cm. The donor areas were covered with full-thickness skin graft.Results:All twenty-three flaps and injuried fingers survived postoperatively. Primary healing was achieved in the donor area wound. Follow-up period ranged from 6 to 36 months, with an average of 18 months. The skin flap was soft, and the color was close to the skin without obvious atrophy. Based on the total active motion of the finger joints(TAM) evaluation criteria for assessing the risk of the system refers to the active range, 16 fingers TAM240 ° ~265 °, is excellent; 5 fingers TAM205 ° ~215 °,which is good; 2 fingers TAM185 ° ~190 °, is medium. Total excellent ratio is91.3%.There is a little pigmentation of skin graft in 11 cases for postoperative wound, no obvious scar contracture and deformity, no obvious influence function.Conclusion :The island skin flaps from the nearby fingers is an ideal procedure for repair the injuries of this kind. One time surgery can repair the surface of a wound, and bridge repair the digital artery defects. The technique is relatively straightforward and safety. The pipe diameter of the blood vessels is advisable.