探讨应用指蹼动脉穿支三角皮瓣立体复位修复小儿指蹼瘢痕的临床效果。

2022年1月至2025年6月，上海交通大学医学院附属瑞金医院烧伤整形与创面修复科收治符合入选标准的指蹼瘢痕患儿34例，其中男19例，女15例，年龄（9.2±2.8）岁，瘢痕形成时间为1~4年。患儿指蹼瘢痕均采用指蹼动脉穿支三角皮瓣立体复位修复，皮瓣切取面积为0.5 cm×0.5 cm~1.5 cm×1.3 cm。术后观察皮瓣成活情况及并发症，随访观察皮瓣外形、色泽及质地，末次随访时采用Withey评分及温哥华瘢痕量表评分评价手部外观及瘢痕增生情况。

34例患儿术后皮瓣均成活良好，未出现皮瓣坏死、血肿等并发症。术后随访6~18个月，皮瓣色泽和质地与周围组织相近，指蹼深度、宽度及坡度均接近正常，无明显瘢痕增生，掌指关节活动正常。末次随访时，34例患儿Withey评分平均0.57分，温哥华瘢痕量表评分平均2.21分。

采用指蹼动脉穿支三角皮瓣立体复位修复小儿指蹼瘢痕，是一种设计简单、效果良好的方式。

To evaluate the clinical efficacy of three-dimensional reconstruction with finger web artery perforator triangular flaps for web space scars in children.

From January 2022 to June 2025，34 pediatric web space scar patients who met the inclusion criteria were admitted to the Department of Burn Plastic Surgery and Wound Repair of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine，including 19 males and 15 females，with a mean age of （9.2±2.8） years and a scar duration ranging from 1 to 4 years. The patients underwent three-dimensional reconstruction with finger web artery perforator triangular flaps. The harvested flap areas ranged from 0.5 cm×0.5 cm to 1.5 cm×1.3 cm. Postoperative flap survival and complications were recorded. The appearance，colour and texture of flaps were assessed during follow-up. The Withey score and Vancouver scar scale （VSS） were adopted to evaluate hand appearance and scar hyperplasia at the last follow-up.

The flaps of all 34 patients survived without necrosis，haematoma or other complications. The follow-up period were 6-18 months. The flaps presented similar colour and texture to the surrounding native tissue； the depth，width and slope of reconstructed finger webs approximated normal anatomical morphology，with no obvious scar hyperplasia and intact metacarpophalangeal joint mobility. At the last follow-up，the mean Withey score was 0.57 and the mean VSS score was 2.21 across all patients.

Three-dimensional reconstruction using finger web artery perforator triangular flaps is a simple and effective method for correcting web space scars in children.