两种微型游离皮瓣修复手指末端缺损的疗效比较  

Comparison of clinical efficacy of two types of mini-flaps in repairing finger-tip soft tissue defects

作　　者：孙海军 邵明磊 张志成 武远鹏 孙同新 许立平 Sun Haijun;Shao Minglei;Zhang Zhicheng;Wu Yuanpeng;Sun Tongxin;Xu Liping(Department of Hand and Foot Surgery,Dongying People's Hospital,Shandong 257091,China)

机构地区：[1]山东省东营市人民医院手足外科,东营257091

出　　处：《中华手外科杂志》2024年第3期202-204,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨两种微型游离皮瓣修复指端Ⅱ度缺损的临床效果.方法自2018年1月至2021年6月我们根据损伤的性质、程度、受伤的指别以及患者的意愿,对20例指端Ⅱ度缺损患者采用[母]趾腓背侧复合组织瓣移植再造(A组),另20例指端Ⅱ度缺损患者采用游离桡动脉腕横纹穿支皮瓣修复(B组).术后随访观察皮瓣存活情况,并对皮瓣进行两点分辨觉(two-point discrimination,2PD)检测,比较两组患者感觉功能恢复情况.结果术后40例皮瓣均存活,随访时间为18~36个月,平均(20.05±10.36)个月,皮瓣质地良好,外形及功能满意.术后随访6、12、18个月时,A、B两组皮瓣的2PD与健侧正常指比较,差异均有统计学意义(P<0.05).结论两种微型游离皮瓣是修复指端软组织缺损的较理想皮瓣,成活率高,感觉功能恢复良好,需合理选择应用.Objective To investigate the clinical efficacy of two types of mini-flaps in repairing the degree Ⅱ finger-tip soft tissue defects.Methods From January 2018 to June 2021,based on the nature and severity of the injury,the type of injury,and the patient's wishes,we used a composite tissue flap from the fibular and dorsal side of the toe to reconstruct 20 patients with degreeⅡfinger defects(Group A),and another 20 patients were repaired using a free radial artery wrist transverse perforator flap(Group B).The survival of the skin flap after surgery was followed up and observed,and the two-point discrimination(2PD)testing on the skin flap was performed.The recovery of sensory function between the two groups of patients was compared.Results All 40 flaps survived after surgery,and the follow-up time was 18 to 36 months,with an average of(20.05±10.36)months.The texture of the flaps was good,and their appearance and function were satisfactory.At postoperative follow-up of 6,12,and 18 months,there were statistically significant differences between the 2PD of the A and B groups of skin flaps and the healthy side of the normal finger(P<0.05).Conclusion Two types of mini-flaps are ideal for repairing finger-tip soft tissue defects,with high survival rates and good sensory function recovery.The reasonable selection and application are necessary.

关 键 词：外科皮瓣 对比研究 [母]趾腓背侧皮瓣 修复 指端缺损 

分 类 号：R658.2[医药卫生—外科学]