摘要
目的:比较拇指桡背侧指动脉穿支螺旋桨皮瓣和传统桡背侧皮瓣修复拇指指端缺损的临床疗效。方法:抽取2018年6月至2019年12月于常熟市第一人民医院采用吻合神经的拇指桡背侧指动脉穿支螺旋桨皮瓣修复患者15例为观察组,另抽取2018年5月前采用传统拇指桡背侧皮瓣修复患者21例为对照组,比较分析两组手术时间、皮瓣早期瘀紫率、创面愈合时间、两点辨别觉、皮瓣成活率及患指关节活动度。结果:术后两组患者皮瓣全部成活,创面均Ⅰ期愈合。术后3 d内,观察组1例皮瓣出现稍瘀紫,对照组5例皮瓣出现不同程度瘀紫,差异有统计学意义(P<0.05)。末次随访时,观察组关节总活动度(TAM)优良率为100%(15/15),对照组为85.7%(15/21),P<0.05。两组皮瓣成活率均为100%,供区均拉拢缝合。两组手术时间比较差异未见统计学意义(P>0.05)。观察组创面完全愈合时间为(14.42±3.35)min,少于对照组的(17.63±4.58)min,P<0.05。观察组和对照组末次随访两点辨别觉分别为(6.23±1.35)、(8.45±1.58)mm,差异有统计学意义(P<0.05)。结论:拇指桡背侧螺旋桨皮瓣修复拇指指端缺损,较传统皮瓣有较大的修复优势,应用价值大。
Objective:To compare the effects of propeller flap of radial dorsal digital artery thumb,and traditional flap of dorsal radial thumb in repairing defects of thumb tip.Methods:A total of 15 patients who underwent the propeller flap of the radial dorsal digital artery of thumb in the First People’s Hospital of Changshu from June 2018 to December 2019 were selected as the observation group.Another 21 patients repaired with the traditional flap of dorsal radial thumb before May 2018 were selected as the control group.The operation time,early purple deposition rate of flap,wound healing time,two-point discrimination,flap survival rate and the motion digital joints were observed and compared between the two groups.Results:All flaps survived,and the wounds healed primarily.Within 3 days after operation,1 case of skin flap in the observation group had stasis purpura,while 5 cases in the control group had varying degrees of stasis purpura,and the difference was statistically significant(P<0.05).At the last follow-up,the excellent and good rate of total active movement(TAM)was 100%(15/15)in the observation group,and it was 85.7%(15/21)in the control group(P<0.05).The survival rate of the flap was 100%in either group,and all the donor area were closed and sutured.There was no statistically significant difference in operation time between the two groups(P>0.05).The time of complete wound healing in the observation group was(14.42±3.35)min,shorter than the(17.63±4.58)min in the control group(P<0.05).At the end of the last follow-up,two-point discrimination of the observation group and the control group was(6.23±1.35)mm and(8.45±1.58)mm,and the difference was statistically significant(P<0.05).Conclusions:Compared with the traditional flap of dorsal radial thumb,the radial dorsal propeller flap of thumb has more advantages,and great application value in repairing the defect of thumb tip.
作者
徐晓晨
张建超
钟贤
李东
郑杰
Xu Xiaochen;Zhang Jianchao;Zhong Xian;Li Dong;Zheng Jie(Department of Plastic and Hand Surgery,Changshu Hospital Affiliated to Soochow University,the First People*s Hospital of Changshu,Changshu 215500,China)
出处
《中国实用医刊》
2020年第21期6-9,共4页
Chinese Journal of Practical Medicine
基金
江苏省常熟市科技发展计划项目(CS201920)。
关键词
穿支皮瓣
螺旋桨皮瓣
桡背侧皮瓣
指损伤
Perforator flap
Propeller flap
Radial dorsal flap
Finger defect
