脱细胞基质神经修复膜在趾腓侧皮瓣重建手指指腹感觉中的应用及疗效评价  

Application and efficacy evaluation of acellular matrix nerve repair membrane in reconstruction of finger pulp sensation with great toe fibular flap

作　　者：陶先耀 唐胤尧 王进 薛明宇 周晓 强力 芮永军 Tao Xianyao;Tang Yinyao;Wang Jin;Xue Mingyu;Zhou Xiao;Qiang Li;Rui Yongjun(Department of Hand Surgery,Wuxi Ninth People's Hospital,Wuxi 214062,China)

机构地区：[1]无锡市第九人民医院手外科,无锡214062

出　　处：《中华手外科杂志》2024年第5期436-439,共4页Chinese Journal of Hand Surgery

基　　金：中国吴阶平医学基金会临床科研专项资助基金(320.6570.2021-4-16)。

摘　　要：目的 探讨脱细胞基质神经修复膜在趾腓侧皮瓣修复手指指腹缺损创面的临床应用效果.方法 自2021年1月至2022年12月我科收治36例采用游离趾腓侧皮瓣修复手指指腹皮肤软组织缺损的患者,分为观察组和对照组,观察组采用脱细胞基质神经修复膜对缝合的神经进行包裹,对照组则未使用,比较两组术后并发症发生率及手指指腹感觉功能恢复效果.结果 术后所有患者均获得随访,时间为12~24个月,观察组平均(14.5±3.2)个月,对照组(15.5±2.8)个月.术后两组皮瓣均顺利存活,伤口 Ⅰ期愈合,未出现皮瓣感染、局部排斥、过敏反应等,术后12个月随访发现观察组的指腹感觉在两点分辨觉、S-W单丝试验等方面显著优于对照组(P<0.05).结论 脱细胞基质神经修复膜修复神经术后未出现明显的局部排斥、过敏反应,具有良好的组织相容性和安全性,有一定的促进感觉恢复的作用.Objective To investigate the clinical application efficacy of acellular matrix nerve repair membrane in repairing the wound defect of finger pulp with great toe fibular flap.Methods From January 2021 to December 2022,36 patients treated with free great toe fibular flap for repairing skin and soft tissue defects of finger pulp were divided into observation group and control group.The sutured nerve in observation group was wrapped with acellular matrix nerve repair membrane,while the control group was not.The incidence of possible postoperative complications and the recovery effect of finger and pulp sensory function were compared between the two groups.Results Postoperatively all patients were follow-up for a period of 12 to 24 months,with an average of(14.5±3.2)months in the observation group and(15.5±2.8)months in the control group.The flaps in both groups survived well after surgery.The wound achieved primary healing after surgery,and no flap infection,local rejection,allergy and other reactions occurred.The observation group was significantly better than the control group in two-point discrimination and S-W monofilament test at 12 months after surgery(P<0.05).Conclusion The acellular matrix nerve repair membrane did not show significant local rejection or allergic reactions after nerve repair surgery,and has good tissue compatibility and safety,which has a certain promoting effect on sensory recovery.

关 键 词：指损伤 外科皮瓣 神经膜 指腹 感觉恢复 

分 类 号：R658.2[医药卫生—外科学]