大鱼际皮瓣联合KELO-COTE~硅凝胶治疗指端软组织缺损伴感染的疗效观察  

Evaluation of thenar flap with KELO-COTE~ silicone gel for infected fingertip defect

作　　者：徐林玉 陆海波 卢道云 王浩 李程远 罗涌 李森 张斌 XU Linyu;LU Haibo;LU Daoyun;WANG Hao;LI Chengyuan;LUO Yong;LI Sen;ZHANG Bin(Department of Surgery,Central Hospital of Dinghai District in Zhoushan City,Zhoushan 316000,China;Hong Kong Garrison Hospital of PLA;Department of Orthopaedics,the 413rd Hospital of PLA;Department of Orthopaedics,the First Affiliated Hospital of General Hospital of PLA)

机构地区：[1]舟山市定海区中心医院外科,浙江舟山316000 [2]解放军驻香港部队医院 [3]解放军总医院第一附属医院骨科 [4]解放军413医院骨科

出　　处：《西北国防医学杂志》2018年第8期523-527,共5页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:观察大鱼际皮瓣联合KELO-COTE~硅凝胶治疗指端软组织缺损伴感染的临床疗效。方法:选择2016-05~2018-04我科32例(38指)指端软组织缺损伴感染行大鱼际皮瓣联合KELO-COTE~硅凝胶治疗患者。术中根据大鱼际区的血供及自然皮肤横纹,在同侧大鱼际肌表面掀起皮瓣覆盖指端创面,术后应用KELO-COTE~硅凝胶抑制瘢痕增生,观察治疗效果。结果:本组32例(38指)患者手指皮瓣断蒂后均存活良好。术后随访3~6个月,皮瓣血运良好,外形满意,质地、色泽与周围正常皮肤相似,大鱼际供区切口均一期愈合,瘢痕不明显,无疼痛不适感,两点辨别觉8~10 mm。伤指的功能评价为优35指,良3指,优良率为100%。术后1个月虎口张开及手指伸直稍受限,经逐步指导功能锻炼后,均恢复正常。Michigan手外科问卷评定为非常满意30例,满意2例。结论:大鱼际皮瓣联合KELO-COTE~硅凝胶治疗指端软组织缺损伴感染,手术成功率高,术区瘢痕不明显,手功能恢复理想,效果满意,值得推广。Objective：To evaluate the therapeutic efficacy of thenar flap combined with KELO-COTE^R silicone gel for infected fingertip defect.Methods：Thirty-two patients（38 fingers）with infected fingertip defect were treated with thenar flaps combined with KELO-COTE^R silicone gel from May 2016 to April 2018.Based on the blood supply and natural skin stripes in thenar area,the flaps were lifted on the surface of the thenar muscles to cover the defects.The KELO-COTE^Rsilicone gel was topically administrated to inhibit scar hyperplasia postoperatively.The therapeutic effect was observed.Results：All flaps survived after pedicle division.During 3 to 6 months of follow-up,all transferred flaps had satisfactory blood supply and appearance,with the contour,quality and color of the flaps similar to those of adjacent normal skin.The incisions in donor site healed well and the scars were indistinct.There was no pain or other discomfort complained.There was 8-10 mm of two-point discrimination at the repaired fingertips.The results of the functional evaluation of the affected fingers showed 35 with excellent and 3 with good,and the percentage of excellent and good was 100%.Although the abductions of the affected thumbs were slightly limited at the first month postoperatively,the thumbs with infected fingertip defect was normolized after progressive functional exercises.The results of the Michigan hand surgical questionnaire also showed 30 fingers with very satisfied and 2 fingers with satisfied.Conclusion：Thenar flap combined with KELO-COTE^R silicone gel show a good efficiency in the treatment of infected fingertip defect,which has high success rate of operation,no obvious postoperative scar,and recovery of hand function.The result is ideal,satisfactory and worth promoting.

关 键 词：大鱼际皮瓣 KELO-COTE硅凝胶 指端缺损 

分 类 号：R622[医药卫生—整形外科]