伴有皮肤缺损的断指再植

Replantation of severed finger combined with skin defect

目的探讨伴有皮肤缺损的断指再植手术方法的选择。方法根据伤指的不同情况分别采用浅静脉皮瓣、邻指皮瓣、侧方旗帜型皮瓣、掌骨背动脉逆行岛状皮瓣及腹部皮瓣修复伤指的血管及皮肤缺损。结果本组病例35指,成活34指。术后2～6个月随访,皮瓣的颜色、质地、外形、感觉恢复均较满意,避免了手指的伤残,恢复了良好的功能。结论应用上述综合方法,一期修复伴血管和皮肤缺损的断指,皮瓣切取方便,术后易于观察,并在临床应用中证实是切实可行的。

Objective To investigate the selection and methods of replantation combined with skin defect.Methods Based on the severed finger injury, different of skin flaps were used to repair the vessel and skin defects, including superficial venous skin flap, interproximal finger flap, lateral flag skin flap, the first dorsal intermetacrpal flap and abdominal flap.Results In 35 fingers of 28 cases, 34 fingers survived.The postoperative following-up period ranged from 2 to 6 months. The color,quality, appearance of flaps and sensation recovery were satisfactory. It also can avoid the finger disability and be beneficial to restore satisfactory function.Conclusion Through the ordinary treatments, the skin defects were repaired primarily. It was convenient to acquire the flap and to observe postoperatively. These methods were probed to be practice.