第二足趾胫侧游离皮瓣修复指掌侧皮肤缺损的临床评估  

Repair finger with the second digit lateral shank flap through free transplantation of lateral defect

作　　者：李达 邓森 

机构地区：[1]广东省高州市中医院手足显微外科,525200

出　　处：《中国医师进修杂志》2015年第10期730-733,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的介绍一种修复手指指掌侧皮肤缺损的理想方法。方法采用第二足趾胫侧皮瓣游离移植修复手指指掌侧缺损35例。男24例，女11例；年龄21～45岁。切割伤7例，挤压伤16例，撕脱伤9例，火器伤3例。皮肤缺损面积2．0cm×1．5cm～4．0cm×2．5cm。病程1h至5d。供区中厚皮片修复。结果术后35例供受区伤口均I期愈合，移植皮瓣及供区植皮均成活。29例获得随访，随访时间5～26（14．5±5．0）个月。皮瓣外形逼真，质地良好，两点辨别觉5～8（6．7±1．1）mm。按中华医学会手外科学会上肢部分功能评定试用标准：优19指，良8指，优良率为93．1％（27／29）。供足行走、跑、跳功能正常。结论第二足趾胫侧皮瓣游离移植修复手指指掌侧缺损，供区损伤小，对受区周围组织破坏小，修复后效果佳，能达到指掌侧修复目的。Objective To introduce an ideal method of repairing of finger volar skin defect. Methods Thirty-five patients whose finger was repaired by second digit lateral shank flap through free transplantation of lateral defect were selected. Twenty-four cases were male and 11 cases were female, with age of 21 to 45 years old. Cutting injury was in 7 cases, crush injury was in 16 cases, degloving injury was in 9 cases, and firearm injury was in 3 cases. Skin defect area was 2.0 cm × 1.5 cm - 4.0 cm × 2.5 cm. The course was 1 h to 5 d. Donor area was repaired by thick skin flap. Results The postoperative wound of 35 cases all healed in stage I , and skin flap transplantation and the donor skin grafts survived. Twenty-nine cases received follow-up for 5 - 26 （14.5 ±5.0） months. The skin flap had good appearance and good texture, with two points discrimination of 5 - 8 （6.7 ± 1.1） mm. According to the Chinese medical association upper part of the function evaluation trial standard： excellent was in 19 fingers, good was in 8 fingers, and the excellent and good rate was 93.1% （27/29）. Walk, run, jump functions of donor foot were normal. Conclusions Repairing finger with the second digit lateral shank flap through free transplantation of lateral defect has small area damage, and damage to the area around the organization is small. The effect of repairing is good, and can achieve the aim of the palm side repairing.

关 键 词：修复外科手术 外科皮瓣 皮肤缺损 

分 类 号：R658.2[医药卫生—外科学]