[足母]甲皮瓣再造指端及供区修复的改良方法  

Modified method of Hallux toe nail flap for finger tip reconstruction and donor site repair

作　　者：周健辉[1] 李秀文[1] 冷树立[1] 李国强[1] 王夫平[1] Zhou Jianhui Li Xiuwen Leng Shuli Li Guoqiang Wang Fuping.(Department of Hand Surgery, Xiaolan Hospital Affiliated to Southern Medical University, Guangdong 528415, China)

机构地区：[1]南方医科大学附属小榄医院手外科,广东中山528415

出　　处：《中华手外科杂志》2017年第4期279-281,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨[足母]甲皮瓣游离移植再造手指远端复合组织缺损及其供区修复的改良方法和治疗效果。方法切取[足母]趾腓侧部分甲床及趾端皮肤组成[足母]甲皮瓣，通过游离移植的方式再造伤指指端缺损部分，[足母]趾供区直接缝合，甲床创面无需植皮或皮瓣修复，等待甲床自行生长修复。自2013年5月至2015年4月，我们应用该方法修复13例15指指端部分甲床及皮肤缺损而无末节指骨明显缺损的患者。结果术后随访时间为3-12个月，[足母]甲皮瓣移植全部存活，指端外形及指甲生长接近正常，指间关节活动良好，[足母]趾趾甲接近完整，外形美观，无明显缺陷。[足母]趾供区无局部疼痛、破溃、感觉障碍等不良表现。结论[足母]甲皮瓣再造指端是修复手指远端复合软组织缺损的较理想方法，供区修复方法的改良使[足母]趾趾端及趾甲外形恢复更好，不留明显后遗症。Objective To discuss the modified method and clinical effect of free hallux toe nail flap for reconstruction of composite tissue defect at finger tip and repair of its donor site. Methods Partial nail bed at fibular side of hallux was cut and combined with toe tip skin to form hallux toe nail flap. The reconstruction of finger tip defects was achieved by free hallux toe nail flap transplantation. The donor site of haUux was sutured directly. Nail bed wound was healed by itself without skin graft or flap repair. From May 2013 to April 2015, 13 cases （15 fingers） had partial nail bed and skin defects at finger tip and no obvious distal phalanx defects, which were repaired by this method. Results All the patients were follow-up for 3 to 12 months. All the free hallux toe nail flap graft survived. The finger tip appearance and nail growth were close to normal. The function of interphalangeal joint was good. Hallnx nail was nearly complete with good appearance and without obvious defect. No local pain, ulceration, and sensory disorder occurred at hallux donor site. Conclusion Hallux toe nail flap is an ideal method for reconstruction of composite tissue defect at finger tip. The improvement of donor site repair method can make better appearance of toe tip and nail without obvious sequelae.

关 键 词：指损伤 外科皮瓣 游离组织移植物 指端缺损 

分 类 号：R658.2[医药卫生—外科学]