摘要
目的比较分析[母]趾腓侧皮瓣与足底内侧皮瓣修复指腹创面的临床疗效。方法回顾性分析自2015年6月至2020年3月我们收治的43例指腹软组织缺损患者,其中应用[母]趾腓侧游离皮瓣移植修复指腹创面22例(A组),应用足底内侧游离皮瓣移植修复指腹创面21例(B组)。术后6个月对两组皮瓣的成活率、皮瓣感觉、供区瘢痕、皮瓣臃肿程度和血液循环状态进行比较分析,采用SPSS 19.0统计学软件进行统计学分析。结果术后A组患者随访时间为6~20个月,平均10.1个月;B组患者随访时间为6~18个月,平均9.5个月。两组皮瓣全部存活,其中A组术后24 h有1例出现静脉危象,B组术后12h有1例出现静脉危象,均予松解敷料,并侧切口放血,后静脉危象解除,顺利存活。供区切口均Ⅰ期愈合。术后6个月随访,两组皮瓣感觉均恢复良好,达到S_(3+)以上,A组两点分辨觉平均恢复至(6.16±0.81)mm,B组恢复至(7.08±0.84)mm,两组差异有统计学意义(t=-9.345,P<0.01);B组供区瘢痕挛缩程度优于A组,两组差异有统计学意义(χ^(2)=4.949,P=0.026);皮瓣臃肿程度通过比较两组皮瓣高出皮面情况,差异无统计学意义(χ^(2)=0.216,P=0.642);血液循环状态从皮肤色泽和温度情况来比较,两组病例均为优或良,差异无统计学意义(χ^(2)=0,P=1.000)。结论[母]趾腓侧皮瓣和足底内侧皮瓣均具有血管解剖恒定,血供可靠,与手部组织结构相近,能够恢复指腹皮纹且无毛发生长,感觉功能恢复满意,供区损伤小等特点,是修复指腹皮肤软组织缺损的较理想皮瓣。
Objective To compare and analyze the clinical efficacy of free hallux fibular flap and medial plantar flap in the repair of finger pulp defects.Methods From June 2015 to March 2020,43 cases of finger pulp skin and soft tissue defects were retrospectively analyzed,of which 22 cases(group A)were repaired with free hallux fibular flap and 21 cases(group B)were repaired with medial plantar flap.Six months after operation,the survival rate,flap sensation,donor scar,flap bloated degree and blood circulation status of the two groups were compared and analyzed.SPSS 19.0 statistical software was used for statistical analysis.Results The patients in group A were follow-up for 6 to 20 months,with an average of 10.1 months.The patients in group B were follow-up for 6 to 18 months,with an average of 9.5 months.All the flaps in the two groups survived,including one case of venous crisis 24 hours after operation in group A and one case of venous crisis 12 hours after operation in group B.all the flaps were given loose dressing and bleeding through the lateral incision.Then the venous crisis was relieved and survived smoothly.All the donor site incisions achieved primary healing.After 6 months of follow-up,the flap sensation of the two groups recovered well,reaching above S3..The average two-point discrimination in group A recovered to(6.16+0.81)mm,and that in group B recovered to(7.08+0.84)mm.The difference between the two groups was statistically significant(t=-9.345,P<0.01).The degree of scar contracture in group B was better than that in group A,and the difference between the two groups was statistically significant(χ^(2)=4.949,P=0.026).There was no significant difference in the degree of flap bloat between the two groups by comparing the flap height above the skin surface(χ^(2)=0.216,P=0.642).Compared with skin color and temperature,the blood circulation status of the two groups was excellent or good,and the difference was not statistically significant(χ^(2)=0,P=1.000).Conclusion The hallux fibular flap and medial planta
作者
李甲
裴广楠
朱辉
滕道练
李海建
郑大伟
寿奎水
Li Jia;Pei Guangnan;Zhu Hui;Teng Daolian;Li Hajian;Zheng Dawei;Shou Kuishui(Department of Hand Surgery,Xuzhou Renci Hospital,Jiangsu 221004,China)
出处
《中华手外科杂志》
CSCD
北大核心
2023年第1期33-37,共5页
Chinese Journal of Hand Surgery
关键词
外科皮瓣
显微外科手术
比较研究
指腹
修复
Surgical flaps
Microsurgery
Comparative study
Finger pulp
Repair
