利用废弃指组织形成皮瓣或组织瓣移植修复邻指损伤  

Flap from abandoned finger or partial finger transplantation in the repair of adjacent finger injury

作　　者：朱从坤 金光哲[1] 熊胜[1] 张广亮[1] 巨积辉[1] ZHU Cong-kun;JIN Guang-zhe;XIONG Sheng;ZHANG Guang-liang;JU Ji-hui(Department of Hand Surgery,Ruihua Affiliated Hospital of Soochow University,Shuzhou 215104,China)

机构地区：[1]苏州大学附属瑞华医院手外科,江苏苏州215104

出　　处：《中国美容整形外科杂志》2020年第12期707-709,734,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨利用废弃指组织形成皮瓣或组织瓣带蒂游离移植修复邻指损伤的手术方法及临床效果。方法自2008年5月至2015年6月,采用废弃指组织形成皮瓣或组织瓣移植修复邻指软组织损伤13例,8例游离移植废弃指皮瓣,2例游离移植废弃指组织瓣,3例带蒂移植废弃指残端皮瓣;9例重建感觉功能。结果术后11例移植废弃指皮瓣或组织瓣顺利成活,伤口一期愈合;2例游离移植废弃指组织皮瓣表皮坏死,经换药后成活。随访8~36个月,平均18个月,移植废弃指皮瓣或组织瓣外形较满意,色泽与邻指相近,重建感觉功能者两点分辨觉达7~9 mm,修复指功能较满意。按中华医学会手外科学会上肢部分功能评定试用标准评定:优7例,良4例,可2例。优良率为84.6%。结论利用废弃指组织形成皮瓣或组织瓣带蒂游离移植修复邻指软组织损伤,将本该废弃的组织充分利用,是一种物尽其用的较好方法。Objective To explore the surgical method and clinical efficacy of flap from abandoned finger or partial finger transplantation in the repair of adjacent finger injury.Methods From May 2008 to June 2015,the flap from abandoned finger or partial finger transplantation was used to treat adjacent finger injury in 13 patients.The free flap from abandoned finger was used to repair the skin defect of adjacent finger in 8 patients,partial finger from abandoned finger was used to repairⅡo defect of adjacent finger in 2 patients,the pedicled flap from abandoned finger was used to repair the skin defect of adjacent finger in 3 patients and the sensation was reconstructed in 9 patients.Results The transplanted finger or flap in 11 patients survived successfully and the wounds healed in one stage.Epidermal necrosis of the transplanted flap occurred in 2 patients and the flaps survived after dressing change.All patients were followed up from 8 to36 months,with an average of 18 months.The appearance of transplanted finger or flap was satisfactory and the color was similar to the adjacent fingers.The two-point discrimination of patients with reconstructed sensation was from 7 mm to 9 mm.The function of repaired finger was satisfactory.According to the upper extremity functional evaluation standard set up by hand surgery branch of Chinese Medical Association,7 cases was excellent,4 cases was good and 2 cases was poor.The excellent and good rate was 84.6%.Conclusion The flap from abandoned finger or partial finger transplantation could cover the wounds of adjacent finger without sacrifice another donor site.Getting the most out of things is a better way to make full of the abandoned finger.

关 键 词：组织瓣 指损伤 废弃指 显微外科技术 

分 类 号：R658.2[医药卫生—外科学]