医用生物胶在部分甲床缺损再生和修复中的临床应用研究  

Clinical application of medical bio-gel in the regeneration and repair of partial nail bed defects

作　　者：李军[1] 李海山[1] LI Jun;LI Hangshan(Emergency Department,Hefei Hospital Affiliated to Anhui Medical University,Hefei 230011,China)

机构地区：[1]安徽医科大学附属合肥医院急诊科,安徽合肥230011

出　　处：《中华灾害救援医学》2021年第7期1131-1134,共4页Chinese Journal of Disaster Medicine

摘　　要：目的探讨急诊急救过程中一种快速简单的治疗部分甲床缺损的新方法及疗效。方法自2016-12至2020-06入组46例共计52指/趾部分甲床缺损病例,伤后6~8 h以内来院,甲床缺损>4 mm,于急诊清创后使用医用生物胶(主要成分α-氰基丙烯酸正丁酯)对缺损创面进行一期封闭治疗,纱布覆盖疏松包扎。结果对入组患者进行3~6个月的临床观察,平均术后3~6周缺损创面生物胶自行脱落,50指/趾一期愈合,2指/趾1周时出现感染,感染创面予二次清创去除胶皮、脓性分泌物及坏死组织,予静脉抗感染药物治疗后感染控制,行生物胶再次覆盖后二期愈合,全部伤指/趾的残留甲床均向远位生长到指骨末端。愈合后伤指/趾无明显色泽沉着,无明显瘢痕增生挛缩,甲生长平坦,外形光亮。结论医用生物胶可以促进缺损甲床的再生和修复,可以快速彻底止血缺损创面,同时一期封闭创面防止细菌感染,该方法是一种快速简单有效经济的甲床缺损修复方法。Objective To explore a fast and simple method for the treatment of partial nail bed defect in the process of emergency treatment and discuss its curative effects.Methods From December 2016 to June 2020,a total of 46 cases with partial nail bed defect of 52 fingers/toes(admitted to the hospital within 6-8 hours after injury,nail bed defect>4mm)were included in the study.After emergency debridement,medical bio-gel(main component:α-cyanoacrylate)was used for one-stage closure treatment.Results According to the clinical observation that was carried out for 3-6 months,the bio-gel fell off spontaneously after 3-6 weeks of operation,50 fingers/toes healed in the first stage.Two fingers/toes developed infections in the first week,which was controlled after a second debridement and anti-infective drug treatment followed by a re-covering of bio-gel.The residual nail bed of all the injured fingers/toes grew to the end of the phalanx.After healing,the injured fingers/toes had no obvious chromatosis,scar hyperplasia nor contracture.All nails grew flat and bright.Conclusion Medical bio-gel could facilitate the regeneration and repair of the defective nail bed,terminate the bleeding of the defect wound quickly and completely,and seal the wound to prevent further bacterial infection.This method is fast,simple,effective and economical for repairing nail bed defects.

关 键 词：医用生物胶 甲床缺损 甲床修复 甲床再生 再生和修复 

分 类 号：R641[医药卫生—外科学]