顺行和逆行岛状皮瓣在手指末节离断伤后皮肤软组织缺损修复中的临床疗效对比

Comparison of Clinical Efficacy Between Anterograde and Retrograde Island Flaps in Repairing Skin and Soft Tissue Defects after Finger Distal Segment Detachment Injury

目的对比顺行和逆行岛状皮瓣在手指末节离断伤后皮肤软组织缺损修复中的临床疗效。方法选取南京市江宁医院2021年4月—2023年4月收治的80例手指末节离断伤患者为研究对象,以红蓝球抽签方式将其随机分为对照组(n=40)及观察组(n=40)。对照组采用指动脉逆行岛状皮瓣修复术治疗,观察组采用指动脉顺行岛状皮瓣修复术治疗。比较两组患者的临床疗效、伤指活动度、伤指血液循环、伤指恢复情况及围手术期并发症发生率。结果观察组的临床治疗有效率为97.50%,高于对照组的85.00%,差异有统计学意义(P<0.05)。观察组的两点辨别觉低于对照组,远侧指间关节活动度大于对照组,指甲长度长于对照组,组间差异有统计学意义(P<0.05)。观察组的血液循环优良率为100.00%,高于对照组的90.00%,差异有统计学意义(P<0.05)。观察组的伤指感觉恢复评分高于对照组,差异有统计学意义(P<0.05)。观察组的并发症发生率为7.50%,低于对照组的25.00%,差异有统计学意义(P<0.05)。观察组的手术时间及创面愈合时间均短于对照组,组间差异有统计学意义(P<0.05)。结论指动脉逆行与顺行岛状皮瓣修复手术的一般情况均较优,但指动脉顺行岛状皮瓣修复术在手指末节离断伤后皮肤软组织缺损修复方面的效果更佳,能更好地促进患者伤指活动及血液循环的恢复,手术时间及术后创面愈合时间均更短,综合疗效更佳,值得临床推广使用。

Objective To compare the clinical efficacy of anterograde and retrograde island flaps in the repair of skin and soft tissue defects after finger distal segment detachment injury.Methods A total of 80 patients with finger distal segment detachment injury admitted to Nanjing Jiangning Hospital from April 2021 to April 2023 were selected as the study objects,and were randomly divided into a control group(n=40)and an observation group(n=40)by red and blue ball drawing.The control group underwent digital artery retrograde island flap repair,and the observation group underwent digital artery anterograde arterial island flap repair.The clinical efficacy,activity of the injured finger,blood circulation of the injured finger,recovery of the injured finger and the incidence of perioperative complications were compared between the two groups.Results The clinical effective rate of the observation group was 97.50%,higher than 85.00%of the control group,the difference was statistically significant(P<0.05).The two-point discrimination of the observation group was lower than that of the control group,and the distal interphalangeal joint motion of the observatioin group was greater than that of the control group,nail length of the observation group was longer than that of the control group,the differences between the groups were statistically significant(P<0.05).The excellent and good rate of blood circulation in the observation group was 100.00%,higher than 90.00%in the control group,and the difference was statistically significant(P<0.05).The score of sensory recovery of injured finger in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 7.50%,lower than 25.00%in the control group,and the difference was statistically significant(P<0.05).The operative time and wound healing time of the observation group were shorter than those of the control group,and the differences between the two groups were statistically significant(P<0.05).Conclusion The general conditions of artery retrograde and anterograde island flaps repair surgery are better,but oligital artery anterograde island flap repair surgery is better in the repair of skin and soft tissue defects after finger distal segment detachment injury,can better promote the recovery of finger activity and blood circulation,and the operation time and postoperative wound healing time are shorter,and the comprehensive effect is better,worthy of clinical promotion and use.