窄蒂单邻指皮瓣修复手指末节套状撕脱伤的临床效果  

Clinical efficacy of a narrow pedicle cross-finger flap in treatment of distal fingertip degloving injuries

作　　者：冯仕明[1] 王爱国[1] 张在轶 陶友伦[1] 周明明[1] Feng Shiming, Wang Aiguo, Zhang Zaiyi, Tao Youlun, Zhou Mingming(Department of Hand and Foot Microinvasive Surgery, Xuzhou Central Hospital, Southeast University, Xuzhou 221009, China)

机构地区：[1]徐州市中心医院手足显微外科,221009

出　　处：《中华医学美学美容杂志》2018年第5期339-342,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨采用窄蒂单邻指皮瓣修复手指末节套状撕脱伤的临床疗效。方法对23例手指末节套状撕脱伤的患者，应用窄蒂单邻指皮瓣进行修复，其中男15例15指，女8例8指。机器绞伤iI例，皮带绞伤7例，冲床伤5例。示指10例，中指2例，环指7例，小指4例。皮瓣切取面积范围2．6cm×1．9cm～6．5cm×2．2cm。术后6个月后，依据疗效满意度评分方法，通过皮瓣愈合、皮瓣感觉、皮瓣形态、皮瓣温度、供区瘢痕5个方面对皮瓣修复术后的疗效进行评价，随访6～18个月。结果术后皮瓣全部成活，22例患者获得临床随访，1例患者失访。患指修复外形满意，皮瓣质地柔软，无臃肿，弹性好，未见明显色素沉着以及瘢痕挛缩。皮瓣两点辨别觉为5～8mm，平均（6．1±1．3）mm。结论窄蒂单邻指皮瓣血运可靠、操作简便、设计灵活、质地优良，可一期重建感觉，是修复2～5指手指末节套状撕脱伤的有效方法之一。Objective To investigate the application of a narrow pedicle cross-finger flap in the treatment of fingertip degloving injuries. Methods Between June 2011and May 2013, 23 patients （23 fingers） suffered from fingertip degloving injuries were treated with a narrow pedicle cross-finger flap. There were 15 males （15 fingers） and 8 females （8 fingers）. Defects were caused by machine crush injury in 11 cases, girdle crush injury in 7 cases and punch press injury in 5 cases. The defects were located on the index finger in 10 cases, long finger in 2 cases, ring finger in 7 cases, and little finger in 4 cases. The flaps sized 2.6 cm × 1.9 cm to 6.5 cm × 2.2 cm. After six months, according to Zhang＇s curative effect satisfaction score method, the efficacy of the treatment was evaluated by five aspects of skin flap healing： flap fleeing, skin flap, flap outline, flap temperature and donor site scar. Results The island flaps were survived completely in 23 patients. After followed-up for 6 to 18 months （one case was lost to follow-up） . The color and texture of the flap were the same to the surrounding nor- mal skin,and the finger shape was satisfactory. There was no pigmentation and contraction relapse of the injured finger. The mean values of static 2-point discrimination were （6.1 ± 1.3） mm （range, 5-8 mm） of the flap. Conclusions The narrow pedicle cross-finger flap can be used to repair the fingertip degloving injuries with the flexible flap design and reliable blood supplement. The flap survives well and the repair area is good. Therefore, it is a good method and strongly recommended for fingertip degloving injuries repair in clinics.

关 键 词：邻指皮瓣 套状撕脱伤 显微外科 

分 类 号：R658.2[医药卫生—外科学]