拇手指全形再造二期整形的效果观察  

Observation on the effect of the second stage plastic surgery for full-shaped reconstruction of thumb and fingers

作　　者：仇申强 王增涛 郝丽文 陈超 刘林峰 张迪 Qiu Shenqiang;Wang Zengtao;Hao Liwen;Chen Chao;Liu Linfeng;Zhang Di(Department of Hand and Foot Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Reconstructive Surgery,Shandong Public Health Clinical Center,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属省立医院手足外科,济南250021 [2]山东省公共卫生临床中心修复重建外科,济南250021

出　　处：《中华损伤与修复杂志（电子版）》2023年第6期485-490,共6页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨拇、手指全形再造术后供受区整形方法及效果。方法收集2008年3月至2023年5月,拇、手指全形再造术后在山东第一医科大学附属省立医院手足外科进行供受区整形的患者共226例(337指),其中多指再造71例,进行2次或2次以上整形手术43例。再造手指缺损程度:Ⅰ~Ⅲ度缺损94例(160指),Ⅳ~Ⅵ度缺损132例(177指)。足部供区整形86例,腹股沟等其他供区整形12例。手指再造手术与整形术的间隔时间为4~102个月,平均15个月。结果术后切口均Ⅰ期愈合,皮肤无坏死,皮瓣全部成活。整形后的再造手指皮肤质地良好,指体匀称,指端饱满,瘢痕轻微;指甲均生长良好,平整美观。再造手指患者满意度评分从整形术前的平均7.6分提高至术后的平均9.3分。[足母]趾活动及足负重行走、跑跳等皆不受影响。腹股沟等其他供区外形改善明显。结论拇、手指再造术后进行合适的整形,可进一步获得更好的供受区外观。Objective To investigate the methods and effects of plastic surgery on donor and recipient areas after thumb and finger reconstruction.Methods From March 2008 to May 2023,a total of 226 cases(337 fingers)of donor and recipient areas after thumb and finger reconstruction were collected,including 71 cases of multiple finger reconstruction and 43 cases of two or more plastic surgeries.The degree of finger defect was gradeⅠ-Ⅲin 94 cases(160 fingers),gradeⅣ-Ⅵin 132 cases(177 fingers).Totally 86 cases of foot donor area and 12 cases of inguinal and other donor area underwent plastic surgery.The interval between finger reconstruction surgery and plastic surgery was 4-102 months,with an average of 15 months.Results All surgical incisions were healed at stage I,without skin necrosis,and all flaps survived.The skin texture of reconstructed finger was satisfactory,with symmetrical finger body,plump fingertip,and minimal scarring.Additionally,the fingernails displayed healthy growth and smoothness.The average score for the reconstructed finger increased from 7.6 points prior to the plastic surgery to 9.3 points post-surgery.The activity of the great toe and weight-bearing walking,running and jumping were not affected.Furthermore,significant improvements were also observed in the appearance of inguinal and other donor areas.Conclusion Appropriate plastic surgery after thumb and finger reconstruction can achieve a better appearance in both the donor and recipient areas.

关 键 词：手指缺损 拇指缺损 手指再造 拇指再造 皮瓣修复 整形 

分 类 号：R658[医药卫生—外科学]