人工真皮联合舌状筋膜瓣修复手指远端缺损骨外露创面的应用及疗效  

Clinical application and clinical efficacy of artificial dermis combined with tongue-shaped fascial flap for repair of distal finger defects with bone exposed wounds

作　　者：周翔 李向荣 秦军 俞俊兴 贾学峰 杜翚 胡刚 张向南 Zhou Xiang;Li Xiangrong;Qin Jun;Yu Junxing;Jia Xuefeng;Du Hui;Hu Gang;Zhang Xiangnan(Department of Hand Surgery,Jiangyin Hospital Affiliated to Nantong University,Jiangyin 214400,China)

机构地区：[1]南通大学附属江阴医院手外科,江阴214400

出　　处：《中华手外科杂志》2023年第4期294-296,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨并分析应用人工真皮联合局部舌状筋膜瓣修复手指远端缺损骨外露创面的临床应用及疗效。方法自2017年8月至2021年12月我科应用人工真皮联合局部舌状筋膜瓣修复手指远端缺损骨外露创面40例45指,拇指9指、示指12指、中指7指、环指8指、小指9指。术后1个月拆除人工真皮,随访观察创面及手功能恢复情况。结果术后随访6~28个月,平均15个月,所有病例手指远端创面完全自行愈合,且质地柔软、色泽红润、外形美观,指端无疼痛及感觉过敏等症状,40指指端感觉恢复至S4,5指恢复至S3+,患者对术后手指恢复满意度:非常满意39例,满意1例。根据中华医学会手外科学会上肢部分功能评定试用标准进行功能评定:优38例,良2例;优良率100%。结论人工真皮联合局部舌状筋膜瓣修复手指远端缺损骨外露创面操作简单,损伤小,是一种安全可靠的微创美学修复方法。Objective To explore and analyze the clinical application and efficacy of artificial dermis combined with local tongue-shaped fascial flap to repair bone exposed wounds of distal finger defects.Methods From August 2017 to December 2021,45 fingers of 40 patients with distal finger defects and bone exposure wounds were treated in our department by artificial dermis combined with local tongue-shaped fascial flap,including 9 fingers of thumb,12 fingers of index finger,7 fingers of middle finger,8 fingers of ring finger,and 9 fingers of little finger.One month after surgery,the artificial dermis was removed and the wound surface and hand function recovery were followed up and observed.Results The postoperative follow-up period ranged from 6 to 28 months,with an average of 15 months.All cases had completely healed wounds on the distal end of the fingers,with a soft texture,rosy color,and beautiful appearance.There were no symptoms of pain or hypersensitivity at the fingertips.The sensation at the fingertips of 40 fingers returned to S4,and 5 fingers returned to S3+.The patient′s satisfaction with postoperative finger recovery was very satisfactory in 39 cases,and satisfactory in 1 case.According to the trial criteria for evaluating the upper limb function issued by the Hand Surgery Society of Chinese Medical Association,38 cases were evaluated as excellent and 2 cases as good.The excellent and good rate was 100%.Conclusion The combination of artificial dermis and local tongue-shaped fascial flap is a safe and reliable minimally invasive aesthetic repair method for repairing bone exposed wounds in distal finger defects,with simple operation and minimal damage.

关 键 词：指损伤 治疗结果 骨外露 人工真皮 创面修复 

分 类 号：R687.3[医药卫生—骨科学]