游离移植定点法改良[足母]甲皮瓣在拇指再造及拇指脱套伤中的应用  

Modified wrap-around free flap through fixed point method for thumb reconstruction and degloving Injury of the thumb

作　　者：赵军[1] 朱爱剑 曾昕明[1] 骆家伟[1] 赵伟华[1] 陈裕祥[1] 李建杭[1] 陈海生[1] 尹志成[1] 

机构地区：[1]东莞市人民医院谢岗院区手外科,广东东莞523590

出　　处：《实用手外科杂志》2016年第4期432-435,共4页Journal of Practical Hand Surgery

基　　金：东莞市2015年科研立项（项目编号：2015105101210）

摘　　要：目的 探讨游离移植定点法改良[足母]甲皮瓣在拇指再造及拇指脱套伤中的临床应用效果.方法 2008年11月-2016年8月,应用游离移植定点法改良[足母]甲皮瓣修复拇指缺损及拇指脱套伤11例.足供区采用带蒂皮瓣转移或植皮修复.结果 11例皮瓣术后全部成活.拇指修复后外形与健侧对比十分接近,运动和感觉功能评价为优良.供区[足母]趾保留原有长度,定点法改良设计的（母）趾底“舌”状皮瓣均成活,采用带蒂皮瓣转移或植皮成活,趾体外观饱满.供足行走、跑步活动观察无明显异常.随访1-22个月未发现（母）趾带蒂皮瓣或植皮有失活、破损.结论 采用游离移植定点法改良[足母]甲皮瓣对拇指缺损再造及拇指脱套伤修复可取得较好临床效果.Objective To evaluate the clinical outcome of modifed wrap-around free f1ap through fixed point method for thumb reconstruction and degloving Injury of the thumb. Methods Form November 2008 to August 2016, 11 cases of thumb defect and degloving injury of the thumb were treated with modified wrap-around free flap to reconstruct the thumb through fixed point method. The donor site was reconstructed by pediculated flap grafting or skin grafting. Results The transferred flaps survived in a1l cases. The repaired thumb had a similar appearance with the other side. And the sensory and movement were good. The donor big-toe was preserved. The tongue-shaped flaps, which was in the weight bearing area of the tibial side of the big toe, all survived. The pediculated grafting flap or grafting skin also survived. The appearance of the thumb was full. The postoperative gait and running was norma1. The patients were followed up 1 to 22 months postoperatively. No failure occured in skin grafting of big-toe. Conclusion It has a good outcome that the modifed wrap-around free flap used to treat the thumb defect and degloving injury of the thumb.

关 键 词：组织移植 外科皮瓣 显微外科手术 [足母]趾 拇指 

分 类 号：R622.1[医药卫生—整形外科]