双足趾皮瓣瓦合修复全手指套脱伤的可行性研究  

Combined double second toe flaps for repairing degioving injuries of the entire finger： a feasibility study

作　　者：张广亮 巨积辉 金光哲 李祥军 王天亮 唐林峰 侯瑞兴 

机构地区：[1]扬州大学临床教学医院苏州瑞华医院手外科,苏州215104

出　　处：《中华手外科杂志》2014年第2期87-89,共3页Chinese Journal of Hand Surgery

基　　金：苏州市科技计划应用基础研究计划（SYSD2012051）

摘　　要：目的探索双足趾皮瓣瓦合修复全手指套脱伤的可行性。方法对20具尸体标本右中指建立全手指套脱伤模型，将创面分为掌侧和背侧两部分，背侧创面应用带足背皮瓣的第二趾甲背皮瓣覆盖，掌侧创面应用对侧足带足背皮瓣的第二趾胫侧皮瓣覆盖，两皮瓣瓦合后修复整个手指创面。结果20例尸体标本中指全手指套脱伤一次手术完成了对创面、指腹和指甲缺损的修复，修复后手指保留原长度，外形美观，与对侧正常手指外形相似，明显克服了第二趾甲皮瓣修复手指指腹膨大、颈部狭窄等缺点。双足第二趾均能够提供足够大小皮瓣来覆盖手指掌背侧的创面。结论带足背皮瓣的第二趾甲背皮瓣和对侧足带足背皮瓣的第二趾胫侧皮瓣瓦合修复全手指套脱伤的手术方式具有可行性。Objeelive To explore the feasibility of using combined double second toe flaps for repairing degloving injuries of the entire finger. Methods Degloving injury of the entire finger was created to the right middle finger in 20 fresh cadaveric specimens. The wound was divided into the dorsal and volar aspects. The dorsal wound was repaired by the second toe dorsal nail-skin flap along with dorsalis pedis flap, while the volar one was repaired by the second toe tibial flap along with dorsalis pedis flap. The two flaps were sutured together to cover the entire finger. Resttlls Wound coverage and restoration of the pulp and nail were accomplished in one operation in all the right middle fingers. The length of the finger was preserved. The appearance of the reconstructed fingers was satisfactory, resembling that of a normal finger. It overcame the limitations of a second toe wrap around flap that presents a bulky pulp and nan^w neck of the reconstructed finger. The second toe flaps from both feet could be extended to the dorsalis pedis flap and thus were large enough to repair the degloving injury of the entire finger. Conclusion It is feasible to cover a completely degloved finger by transferring second toe dorsal nail-skin flap with dorsalis pedis flap and contralateral second toe tibial flap with dorsalis pedis flap.

关 键 词：指 外科皮瓣 套脱伤 移植 趾 

分 类 号：R658.2[医药卫生—外科学]