关键词: 皮肤缺损, 手部, 掌背动脉皮瓣, 疗效, 皮瓣血运, 运动功能, 感觉功能, 美观满意度

Abstract: Objective To investigate the effect of modified dorsal palmar artery flap in repairing skin defect of hand. Methods A prospective study was conducted on 78 patients with hand skin defects in our hospital from May 2018 to May 2023,who were randomly divided into a control group (n=39) and a study group (n=39) using a random number table method.The control group was given conventional flap repair,while the study group was given modified dorsal metacarpal artery flap repair.The surgical conditions,flap blood supply,motor function of the affected finger,sensory function,postoperative complications and appearance satisfaction of the two groups were compared.Results The operation time,hospital stay and wound healing time of the research group were (110.28±17.65)minutes,(8.94±1.76) d and (14.39±3.82)d,respectively.Which were shorter than the control group [(121.43±15.94)min,(10.13±1.88)d,and (16.51±4.07)d,respectively].The intraoperative blood loss in the research group was (38.12±7.81)ml,which was lower than that of the control group [(42.59±7.43)ml].The elasticity scores of the study group at 1 month,3 months,and 6 months after surgery were (1.31±0.28),(2.34±0.31),and (2.81±0.08),respectively,which were higher than those of the control group [(1.12±0.25),(2.05±0.28),and (2.59±0.17),respectively].The capillary filling time scores were (1.24±0.26),(2.42±0.27),and (2.75±0.12),respectively,which were higher than those of the control group (1.06±0.23),(2.13±0.25),and (2.43±0.27),respectively;the excellent and good rate of motor function of the affected fingers in the study group was 97.44%,which was higher than that of the control group (79.49%),the incidence of complications was 5.13%,which was lower than that of the control group (23.08%),the appearance satisfaction rate was 89.74%,which was higher than that of the control group (71.79%) (P<0.05).Conclusion The modified dorsal palmar artery flap for the treatment of hand skin defects can optimize the operation process,improve the local blood flow of the flap,promote the recovery of finger motor function and sensory function,enhance the appearance effect and reduce the risk of complications.

Key words: skin defect, hands, dorsal metacarpal artery flap, curative effect, flap blood transport, motor function, sensory function, aesthetic satisfaction