医用无菌手套辅助下裁剪布样在手指脱套缺损修复中的应用  

Application of medical sterile gloves-assisted cutting cloth sample in repairing finger degloving injury

作　　者：侯桥 陆金琴 葛梅 庄伟 洪锋 瞿钢 全仁夫 刘玲芬 富红梅 Hou Qiao;Lu Jinqin;Ge Mei;Zhuang Wei;Hong Feng;Qu Gang;Quan Renfu;Liu Lingfen;Fu Hongmei(Second Area of Hand Surgery Department,Jiangnan Hospital Affiliated with Binjiang College of Zhejiang University of Traditional Chinese Medicine,Hangzhou 311200,China)

机构地区：[1]浙江中医药大学滨江学院附属江南医院手外科2病区,杭州311200

出　　处：《中华整形外科杂志》2023年第8期873-878,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨医用无菌手套辅助下裁剪布样在手指脱套缺损修复中的应用效果。方法回顾性分析2015年4月至2021年12月于浙江中医药大学滨江学院附属江南医院治疗的手指皮肤软组织脱套性缺损患者的临床资料。术中采用医用无菌手套辅助制作指体缺损的布样,再按布样切取足背部皮瓣或甲皮瓣修复指体缺损。术后观察皮瓣成活情况及指体外观;调查患者对手部外观及功能的满意度;采用中华医学会手外科学会上肢部分功能评定试用标准评价手指功能。结果共纳入12例患者(13指),男9例(10指),女3例(3指);年龄17~54岁,平均37岁;左手5例(5指),右手7例(8指),均为单侧手指损伤。术中切取的足背部皮瓣及甲皮瓣恰到好处,面积为5.5 cm×4.5 cm~10.5 cm×5.8 cm。术后随访3~15个月,平均7个月,移植的足背部皮瓣及甲皮瓣全部成活,指体外观不臃肿,患者对手部外观及功能均非常满意;手指功能评价:优7例,良5例。结论应用无菌手套辅助裁剪布样修复手指脱套损伤,可以简化手术操作,减少供区的损伤,做到缺多少补多少,使修复的手指获得较好的外形和功能。Objective To investigate the application effect of medical sterile gloves-assisted cutting cloth samples in the repair of finger degloving injury.Methods The clinical data of patients with finger skin and soft tissue degloving defects treated in Jiangnan Hospital Affiliated with Binjiang College of Zhejiang University of Traditional Chinese Medicine from April 2015 to December 2021 were analyzed retrospectively.Medical sterile gloves were used to make cloth samples of finger defects,and then the dorsal foot flap or toenail flap was cut according to the cloth samples to repair finger defects.The survival of flaps and the appearance of the fingers’body were observed after surgery,and the patients’satisfaction was investigated.The finger function was evaluated by the trial standard of upper limb function evaluation of the Hand Surgery Society of Chinese Medical Association.Results A total of 12 patients with 13 fingers were enrolled.There were 9 males(10 fingers)and 3 females(3 fingers),aged 17-54,average of 37-year-old.There were 5 cases(5 fingers)in the left hand and 7 cases(8 fingers)in the right hand,all with unilateral finger injury.The size of the dorsal flaps and great toenail flaps harvested were appropriate,ranging from 5.5 cm×4.5 cm to 10.5 cm×5.8 cm.After surgery,all patients were regularly followed up for 3-15 months,an average of 7 months.All the dorsal flap and great toenail flap of the foot after surgery survived,and the appearance of the finger body was not bloated.All patients were very satisfied with the appearance and function of the hand,and the finger function was evaluated as excellent in 7 cases and good in 5 cases.Conclusion The application of sterile gloves-assisted cutting cloth samples for the treatment of finger degloving injury can simplify the procedure,reduce donor damage,make up for the lack as much as needed,and the repaired fingers can obtain better shape and function.

关 键 词：外科皮瓣 外科手套 解剖模型 指损伤 移植 

分 类 号：R658.2[医药卫生—外科学]