目的 探讨应用胫后动脉穿支逆行岛状皮瓣修复小腿中下段胫前创面的临床效果.方法 对2013年5月-2014年5月收治的10例小腿中下段胫前创面采用胫后动脉穿支逆行岛状皮瓣修复,供区游离植皮.结果 术后10例皮瓣全部顺利成活,小腿供区创面植皮后全部成活,随访2～12个月,皮瓣血运良好,色泽接近周围正常皮肤,外形无臃肿,厚薄适中,有部分感觉恢复.结论 胫后动脉穿支逆行岛状皮瓣不牺牲胫后动脉主干、小腿深筋膜、大隐静脉和隐神经,以内踝尖上4.0～10.0 cm节段内穿支为蒂,可以修复小腿中下段胫前创面,适应证广,血管表浅恒定,手术操作简单,手术时间短,成活率高,外形佳,值得推广.

对20例22指示、中、环、小指指端组织缺损的患者，采用指动脉皮支血管网逆行皮瓣转移修复。20例患者皮瓣完全成活，皮瓣外观、质地、感觉良好。该皮瓣具有指动脉皮瓣相似的疗效，且不损伤指动脉。

目的 探讨应用胫前动脉的前踝上皮支皮瓣逆行转移修复足部不同部位创面的临床效果.方法 对15例足部不同部位的创面,采用胫前动脉的前踝上皮支皮瓣逆行转移修复,供皮瓣区游离植皮.结果 15例皮瓣全部顺利成活,小腿供区创面植皮后全部成活.随访2～12个月,皮瓣血运良好,色泽接近周围正常皮肤,外形无臃肿,厚薄适中,有部分感觉恢复.结论 该皮瓣可以修复足部任何部位创面,适应证广,血管表浅,手术操作简单,成活率高,外形佳,值得临床推广.

Objective To summarize and analyze the technical problems and clinical experiences in severed finger replantation.Methods Totally 1 432 severed fingers in 1 000 cases were replanted.Severed blood supply was reconstructed and tendons were repaired by using the methods of debridement,fixing bone,repairing tendon,vascular anastomosis,nerve anastomosis,blood vessels and tendons shift,palmar finger artery island flap transposition and adjacent dorsal vein island flap transposition etc.Function practice was started two weeks after operation and Kirschner wire was pulling out at 4th week postoperatively to strengthen the joint function exercises.Results There were 1 315 survived fingers and 117 necrotic fingers,the survival rate reaching 91.83%.In all survived fingers,941 fingers were excellent,244 fingers were good,86 finger were fair and 44 fingers were poor according to function evaluation standard,the total excellence and good rate amounting to 90.11%.Conclusion Thorough debridement is the basic premise of successful replantation,fine vascular anastomosis is the key to success and first phase nerve repair and timely functional exercise are the important method for finger functional recovery.

目的 报道应用指动脉终末背侧支岛状皮瓣修复手指甲根平面以远皮肤软组织缺损的手术方法.方法 对19例指端甲根平面以远皮肤软组织缺损者,采用指动脉终末背侧支岛状皮瓣转移修复创面,前臂取皮供区植皮术.结果 术后19例皮瓣中,18例顺利成活,1例部分坏死,给予换药后完全愈合,供区植皮全部成活.随访2～15个月,皮瓣外观、功能、质地满意,浅感觉存在,深感觉较差.结论 指动脉终末背侧支岛状皮瓣是修复指端甲根平面以远皮肤软组织缺损的理想手术方式.