改良术式治疗重度嵌甲临床疗效观察  

MODIFIED SURGICAL REPAIR OF SEVERE INGROWN TOENAIL

作　　者：贾赤宇[1] 李鹏程[1] 吴玉家[1] 邱亚斌[1] 曹令[1] 常春娟[1] 张杨杨[1] 

机构地区：[1]解放军第309医院烧伤整形科,北京100091

出　　处：《中国修复重建外科杂志》2013年第7期869-871,共3页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：北京市自然科学基金资助项目(7123229;7122179);全军医学科技"十二五"重点课题资助项目(BWS11C061);国家重点基础研究发展计划(973)资助项目(012CB518104);中国博士后科学基金面上资助项目(2012M512081)~~

摘　　要：目的总结采用拔甲联合坏死组织和嵌入部分甲床彻底切除及甲周整形改良术式治疗重度嵌甲的临床疗效。方法 2005年1月-2010年12月,收治13例16趾重度嵌甲患者。男12例15趾,女1例1趾;年龄18～32岁,平均20岁。病程1～15年,平均2年9个月。均为趾;其中3例双侧,10例单侧。术中完整切除甲缘周围肉芽组织及嵌入趾甲、坏死甲床,用拉力胶将患侧甲侧壁创缘向中间甲床靠拢。结果术后3～5 d首次更换敷料时,见伤口充血减轻,肿胀消退、分泌物少;7 d时伤口干燥,可见新甲床形成;2周后伤口均愈合,裸露甲床已上皮化,患侧甲侧壁向甲板靠拢愈合良好,患者均恢复正常生活。拔甲后6个月均长出新趾甲,新甲沟形成。患者均经24个月随访未见复发。结论该改良术式具有保留外观好、复发率低等特点,是治疗重度嵌甲的有效方法之一。Objective To summarize the effectiveness of modified surgical repair for severe ingrown toenail. Methods Between January 2005 and December 2010, 13 patients with severe ingrown toenail （16 toes） were treated. There were 12 males （15 toes） and 1 female （1 toe）, aged 18-32 years with an average of 20 years. The disease duration was 1-15 years （mean, 2 years and 9 months）. All affected toes were great toes. Ingrown toenail occurred bilaterally in 3 cases and unilaterally in 10 cases. Granulation tissue surrounding nail-edge, embedded toenail, and necrotic nail bed were completely removed; tension glue was used to make wound edge close to nail bed. Results At 3-5 days after operation, wound congestion, swelling, and exudation were improved; at 7 days, new nail bed formed; at 2 weeks, all wounds healed, and nail bed was epitheliogenic, wound edge healed well close to nail plate, and patients returned to normal life. At 6 months after nail extraction, new toenail grew and nail groove formed. No recurrent sign was found during 24-month follow-up. Conclusion Modified surgical repair is one of effective methods to treat severe ingrown toenail with the advantages of good appearance and low recurrent rate.

关 键 词：重度嵌甲 改良术式 复发 

分 类 号：R758.72[医药卫生—皮肤病学与性病学]