同指指动脉顺行岛状皮瓣联合人工真皮修复指端缺损伴指骨外露  

Same Finger Artery Island Flap Combined with Artificial Dermis for Fingertip Defect with Bone Exposure

作　　者：卢耀开 王锡雄 郑志雄 符毅 LU Yaokai;WANG Xixiong;ZHENG Zhixiong;FU Yi(Qinzhou First People’s Hospital,Qinzhou 535000,China;不详)

机构地区：[1]钦州市第一人民医院暨广西医科大学第十附属医院,广西钦州535000

出　　处：《中外医学研究》2020年第17期122-123,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研项目(Z20180256)。

摘　　要：目的:探讨同指指动脉顺行岛状皮瓣联合人工真皮修复指端缺损伴指骨外露的临床效果。方法:选取2018年1月-2019年10月在笔者所在科室住院的指端缺损伴指骨外露患者28例(36指),采用同指指动脉顺行岛状皮瓣联合人工真皮修复。术后给予常规预防感染、伤口换药处理,早期鼓励患者行患指主动、被动屈伸活动。术后3周拆除皮耐克表层硅胶膜,若仍未愈合通过继续换药至指端缺损完全上皮化。术后1个月记录创面愈合情况,术后3个月记录患指外观、感觉恢复、指关节活动度。结果:28例36指皮瓣均完全存活,术后1个月指端创面组织生长良好,无骨外露。随访3个月,创面均愈合,指端饱满有弹性,感觉恢复良好,指关节活动度接近正常。患者手功能情况,优26例32指,良2例4指。结论:应用同指指动脉顺行岛状皮瓣联合人工真皮修复指端缺损伴指骨外露临床效果良好。Objective:To explore the clinical effect of the same finger artery island flap combined with artificial dermis to repair the fingertip defect with bone exposure.Method:From January 2018 to October 2019,28 patients (36 fingers) with fingertip defect and bone exposure who were hospitalized in the author’s department were selected,and were repaired with the same finger artery island flap combined with artificial dermis.After the operation,routine infection prevention and wound dressing change were given,and patients were encouraged to do active and passive flexion and extension of the fingers in the early stage.Three weeks after surgery,the surface silicone membrane of pinac was removed,and if it still did not heal,the fingertip defect was completely epithelization by continuous dressing change.Wound healing was recorded one month after surgery,and the appearance,sensation and range of motion of the affected finger were recorded three months after surgery.Result:All the 28 cases of 36 finger flaps survived completely,and the wound tissue of the finger end grew well and no bone was exposed one month after the operation.After 3 months of follow-up,the wounds healed,the fingers were full and elastic,and the feeling was good.The range of motion of the knuckles was close to normal.The hand function of the patients was excellent in 26 cases with 32 fingers and good in 2 cases with 4 fingers.Conclusion:The clinical effect of repairing the fingertip defect with bone exposure by the same finger artery island flap combined with artificial dermis is good.

关 键 词：同指指动脉顺行岛状皮瓣 人工真皮 指端缺损伴指骨外漏 

分 类 号：R658.2[医药卫生—外科学]