带趾骨拇甲瓣联合游离股前外侧皮瓣辅助术后高压氧治疗拇指缺损  

Surgical Treatment of Thumb Defect with Hallux and Nail Flaps with Toe Bones and Free Anterolateral Thigh Skin Flaps Assisted by Hyperbaric Oxygen

作　　者：宋利华 SONG Li-hua(Jizhong Energy Xingtai Mining Group Co.Ltd.General Hospital,Xingtai 054000,Hebei,China)

机构地区：[1]冀中能源邢台矿业集团有限公司总医院

出　　处：《中国美容医学》2019年第10期14-17,共4页Chinese Journal of Aesthetic Medicine

基　　金：2017年邢台市科技计划(名称:VSD联合游离皮片移植术后高压氧治疗手部严重软组织缺损临床研究;编号:2017ZC053)

摘　　要：目的:分析带趾骨拇甲瓣联合游离股前外侧皮瓣辅助术后高压氧治疗手部拇指缺损的临床效果。方法:回顾性分析笔者医院2014年1月-2017年1月收治的手部拇指缺损的32例患者的临床资料,对其实施带趾骨拇甲瓣联合游离股前外侧皮瓣移植修复手部缺损,并于术后接受高压氧治疗。观察患者术后移植组织成活率、手部、足部功能。结果:32例患者的移植组织均存活,手部再造区两点辨别觉达5~9mm,可行常规手部活动。术后患者的站立、行走功能未受明显影响。头部皮肤在移植至股前外侧皮瓣供区后7~12d存活,无明显刺痛、瘙痒等不良反应发生,但存在4例患者在移植后早期出现脱屑样改变,随访过程中改善。头部供皮区愈合良好,未出现脱发现象。结论:带趾骨拇甲瓣联合游离股前外侧皮瓣辅助术后高压氧治疗手部大面积缺损效果良好,值得在临床实践中推广。Objective To study the effect of wrap-around flap from the big toe and anterolateral thigh flap transfer combined with post-operative hyperbaric oxygen therapy in thumb reconstruction.Methods Totally,32 cases of patients with large area thumb defects were enrolled in the study from January 2014 to January 2017 in our hospital.The toe nail flap combined with,free anterolateral thigh flap were translated to repair hand injury.What s more,the patients received hyperbaric oxygen therapy after operation.The survival rate of transplant tissue,hand and foot functions of the patients were observed after surgery.Results The transplant tissues of 32 patients all survived after surgery.The repaired hands had normal function,with two-point discrimination of 5-9mm.After transplantation,there were no obvious effects on the walking function,and the transplanted scalp in the anterolateral thigh region survived within 7-12d.Although there was no obvious pain,pruritus and other adverse reactions on the anterolateral thigh region,4 patients had desquamation symptom,however,the symptom remissive during the follow-up.The donor area on the head healed well and no alopecia was observed.Conclusion There are good effects on the hand repair using wrap-around flap from the big toe and anterolateral thigh flap combined with post-operative hyperbaric oxygen therapy,which means it could be widely applied in clinical practice.

关 键 词：拇指缺损 外科皮瓣 高压氧 移植修复 

分 类 号：R622[医药卫生—整形外科]