六边形皮瓣重建指蹼在先天性并指畸形中的应用  

Clinical effect of using hexagonal skin flap to reconstruct the web of fingers in congenital syndactyly

作　　者：吴华萍 陈后平[1] 张问广[1] 莫安华 侯立松 任冲 李浩 孙俊康 WU Huaping;CHEN Houping;ZHANG Wenguang;MO Anhua;HOU Lisong;REN Chong;LI Hao;SUN Junkang(Department of Pediatric Surgery,The Maternal and Child Health Hospitalof Guiyang,Guiyang 550003,China)

机构地区：[1]贵阳市妇幼保健院小儿外科,贵州贵阳550004

出　　处：《中国美容整形外科杂志》2024年第7期411-414,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨六边形皮瓣重建指蹼在先天性并指畸形中的临床效果。方法 回顾性分析自2018年12月至2022年1月,贵阳市妇幼保健院小儿外科收治的43例先天性并指畸形患儿,按手术方式将患儿分为两组,观察组23例(26个并指)应用掌背六边形皮瓣,对照组20例(22个并指)采用传统的掌背侧三角皮瓣;收集并对比两组围手术期及随访资料。结果 术后1个月两组患儿的指蹼外形、屈伸活动满意,无瘢痕挛缩,组间比较差异无统计学意义(P>0.05)。术后6个月,观察组指蹼外形满意率为100%、屈伸活动度满意率为100%、瘢痕挛缩率为0,对照组指蹼外形满意率为75.0%、屈伸活动度满意率为80.0%、瘢痕挛缩率为20.0%,组间比较差异具有统计学意义(P<0.05)。术后12个月,观察组指蹼外形满意率为91.3%、屈伸活动度满意率为100%、瘢痕挛缩率为0、再次手术率为0,对照组指蹼外形满意率为65.0%、屈伸活动度满意率为80.0%、瘢痕挛缩率为20.0%,再次手术率为20.0%,组间的比较差异具有统计学意义(P<0.05)。结论 采用掌背六边形皮瓣重建指蹼治疗先天并指畸形,指蹼及指根部无需植皮,完全性并指及皮肤紧张并指指侧方取全厚皮片植皮,手指外观及功能良好,临床效果较满意,降低了挛缩畸形及再次手术率。Objective To explore the clinical effect of using hexagonal skin flaps to reconstruct the finger web.Methods A to-tal of 43 cases of congenital syndactyly diagnosed and treated from December 2018 to January 2022 were collected and divided into two groups according to surgical procedures.Among 23 cases(26 syndactyly)were treated with a palmar dorsal hexagonal skin flap as the ob-servation group,while 20 cases(22 syndactyly)were treated with a traditional palmar dorsal triangular skin flap as the control group;collect and compare the perioperative and follow-up data of the two groups.Results One month after surgery,the appearance and flexion and extension activities of the two groups of patients were satisfactory,without scar contracture,and there was no significant difference between the groups(P>0.05).After 6 months of surgery,the satisfaction rate of the observation group finger web appearance was 100%,flexion and extension activity was 100%,and the scar contracture rate was 0.The satisfaction rate of the control group finger web appearance was 75.0%,the satisfaction rate of flexion and extension activity was 80.0%,and the scar contracture rate was 20.0%.There was a significant difference between the two groups(P<0.05).After 12 months of surgery,the satisfaction rate of the observation group finger web appear-ance was 91.3%,the satisfaction rate of flexion and extension activity was 100%,the scar contracture rate was 0,and the reoperation rate was 0.The satisfaction rate of the control group's finger web appearance was 65.0%,the satisfaction rate of flexion and extension activity was 80.0%,the scar contracture rate was 20.0%,and the reoperation rate was 20.0%.The comparison between the groups was significant(P<0.05).Conclusion The application of the palm back hexagonal flap to reconstruct the finger web for treatment of congenital syndacty-ly.There is no need for skin grafting on the finger web and its roots,complete syndactyly and skin tension,and full thickness skin grafting is taken from the side of the finge

关 键 词：六边形皮瓣 指蹼 并指畸形 重建 

分 类 号：R726.8[医药卫生—儿科]