摘要
目的探讨应用邻指带蒂皮瓣嵌合皮下筋膜瓣修复手部YamanoⅠ型断指再植通血失败病例的手术方法和临床疗效。方法2020年4月-12月收治12例手部YamanoⅠ型断指再植失败通血病例,应用邻指带蒂皮瓣嵌合皮下筋膜瓣修复断指以远掌侧及背侧创面,皮瓣供区游离植皮。结果术后皮瓣及皮下筋膜完全成活,挽救断指保留长度及良好手指外观,创面一期愈合。12例均获得随访,随访时间8~40周,平均19周。末次随访时皮瓣质地柔软,背侧甲床正常生长,指体外观无臃肿,皮瓣肤色色素沉着轻,皮瓣两点辨别觉5~12 mm,平均8 mm,手指功能根据总活动度(TAM)法评定,12例均为优,皮片成活良好,轻度瘢痕,轻度局部色差。结论应用邻指带蒂皮瓣嵌合皮下筋膜瓣修复手部YamanoⅠ型断指再植通血失败病例,手术方法可行并可获得良好临床疗效。
Objective To explore the surgical method and clinical curative effect of adjacent pedicle flap and chimeric subcutaneous fascia flap to repair the YamanoⅠamputation after replantation failure.Methods Between April 2020 and December 2020,12 adjacent cases of digital YamanoⅠreplantation failure were repaired,useing chimeric subcutaneous fascia flap and pedicle flap to repair volar and dorsal amputation wound,skin graft for the flap donor.Results Postoperative flap and subcutaneous fascia flap survived completely,saved and reserved length and good appearance,finger amputation wound obtained one stage healing,12 cases received follow-up,follow-up of 8~40 weeks time,an average of 19 weeks,texture was soft,at the time of the last follow-up flap,dorsal nail bed had normal growth,without bloated appearance,light skin pigmentation,two-point discrimination was 5~12 mm,the average 8 mm,finger function method(TAM)according to the total mobility evaluation,12 cases were excellent,the skin graft survived well,mild scar,mild local color.Conclusion Application of adjacent pedicle flap and chimeric subcutaneous fascia flap to repair digital YamanoⅠtype of replantation failure cases of surgical method is feasible with good clinical efficacy.
作者
郑颂耀
ZHENG Songyao(Huiyang Bone Setting Hospital,Huizhou,Guangdong,516211,China)
出处
《实用手外科杂志》
2022年第1期85-88,共4页
Journal of Practical Hand Surgery
基金
惠州市科技计划项目(项目编号:210415154572254)。
关键词
邻指带蒂皮瓣
皮下筋膜瓣
甲床部分缺损
嵌合
Pedicled skin flap of adjacent finger
Subcutaneous fascia flap
Part of the nail bed defect Chimeric
