人工真皮上皮化与指动脉皮瓣修复手指小面积创面疗效对比  

Comparison of epithelialization with artificial dermis and digital artery flap repair for small finger wounds

作　　者：张家盛[1] 王锦辉 陈建永 杨松[1] 高峻青[1] ZHANG Jia-sheng;WANG Jin-hui;CHEN Jian-yong;YANG Song;GAO Jun-qing(Department of Reconstruction Surgery,the Eighth Clinical Medical College,Guangzhou University of Traditional Chinese Medicine,Foshan 528200,Guangdong,China;不详)

机构地区：[1]广州中医药大学第八临床医学院修复重建外科,广东佛山528200 [2]饶平县中医医院骨伤科,广东潮州521000

出　　处：《广东医学》2024年第12期1571-1576,共6页Guangdong Medical Journal

基　　金：广东省基础与应用基础研究基金项目(2022A1515220061);广东省重点领域研发计划项目(2020B1111150001);佛山市卫生健康局医学科研课题(20230097);佛山市中医院登峰计划科研项目(202000204)。

摘　　要：目的探讨人工真皮上皮化与指动脉皮瓣修复手指小面积创面的临床效果。方法分析2021年1月至2023年6月采用人工真皮修复43例47指(真皮组)、指动脉皮瓣修复45例48指(皮瓣组)的患者资料,对比两组患者住院时间、创面愈合时间、皮肤两点辨别觉,创面瘢痕质量(VSS),手功能评分(MHQ)。结果对比两组患者的性别、年龄、受伤原因、伤指部位、缺损面积及随访时间等基线指标,差异无统计学意义(P>0.05),两组具有可比性。对比两组住院时间,真皮组(5.64±3.17)d,皮瓣组(10.88±4.98)d,对比两组患者创面愈合时间,真皮组(28.62±5.34)d、皮瓣组(17.81±2.70)d,差异有统计学意义(P<0.05)。对比两点辨别觉,真皮组(4.70±0.73)mm、皮瓣组(4.74±0.71)mm,差异无统计学意义(P>0.05)。真皮组MHQ手功能评分为(87.18±3.73)分,高于皮瓣组(80.81±4.85)分,差异有统计学意义(P<0.05);对比VSS评分,真皮组(4.23±1.07)分,皮瓣组(4.29±1.15)分,差异无统计学意义(P>0.05)。结论人工真皮上皮化与指动脉皮瓣修复手指小面积肌腱或骨外露创面效果良好,其中人工真皮操作简便、手功能恢复更好,是临床上一种可供选择的方式。Objective To investigate the clinical effects of epithelialization with artificial dermis versus digital artery flap repair for small finger wounds.Methods A retrospective analysis was conducted on 43 cases(47 fingers)treated with artificial dermis and 45 cases(48 fingers)treated with digital artery flap repair from January 2021 to June 2023.The two groups were compared based on hospital stay duration,wound healing time,two-point discrimination,scar quality(VSS),and hand function scores(MHQ).Results Baseline characteristics,including sex,age,cause of injury,affected fingers,defect area,and follow-up duration,showed no significant differences between the groups(P>0.05),indicating comparability.The hospital stay was shorter in the artificial dermis group[(5.64±3.17)days]compared to the flap group[(10.88±4.98)days].The wound healing time was significantly shorter in the artificial dermis group[(28.62±5.34)days]than in the flap group[(17.81±2.70)days](P<0.05).Two-point discrimination was similar between groups[(4.70±0.73)mm vs.(4.74±0.71)mm,P>0.05).The MHQ score was higher in the artificial dermis group(87.18±3.73)compared to the flap group(80.81±4.85)(P<0.05).VSS scores showed no significant difference(4.23±1.07 vs.4.29±1.15,P>0.05).Conclusion Both artificial dermis epithelialization and digital artery flap repair are effective for small tendon or bone-exposed finger wounds.However,the use of artificial dermis is simpler and results in better functional recovery,making it a viable option in clinical practice.

关 键 词：人工真皮 指动脉皮瓣 手指 创面修复 

分 类 号：R649.9[医药卫生—外科学] R622.1[医药卫生—临床医学]