浸泡末节断指再植30指失败6指指背筋膜蒂皮瓣修复体会

Reimplantation of the distal segment of fingers for 30 amputated fingers and the 6 failure fingers stump were repaired with the fascial pedicle dorsal flap of finger

目的探讨液体浸泡过的手指末节完全离断再植的必要性以及失败后的二期处理措施。方法对应用液体浸泡过的末节离断伤再植25例30指进行研究,采用动静脉1∶2吻合法再植18指,采用动静脉1∶1血管吻合法再植12指,失败的6指二期行扩创指背筋膜蒂逆行岛状皮瓣修复残端以尽可能多的保留患指的长度和功能。结果再植浸泡完全性末节离断30指,成活24指,成活率为80%。失败的6指行指背筋膜蒂岛状皮瓣逆行转移修复残端,皮瓣成活良好,外观功能满意。结论液体浸泡时间较短且挫伤较轻的末节断指应尽可能再植。对于再植术后失败者,二期应用指背筋膜蒂皮瓣逆行转移修复残端是尽可能多的保存患指长度及功能较为实用的手术方式。

Objective To investigate the replantation essentiality of the distal phalanx soaked with liquid and the distal amputated finger disposal measure after the replantation failure. Methods A study was carried out in 30 distal phalanx replanted fingers of 25 cases. 18 fingers were replanted with the method of which the AtV rate is 1：2, and 12 fingers were replanted with the method of which the AtV rate is 1： 1. The six failure amputated fingers were expanded raw surface and were repaired with the reverse fascial pedicle dorsal island flap of finger. As far as possible to retain the wound fingers＇ length and function. Results Among 30 replantations of the soaked finger-end severing, 24 fingers were survival and the survival rate was 80%. The six failure amputated finger stumps were repaired with the reverse fascial pedicle dorsal island flap of finger, the flaps were survive well. Satisfactory appearance and function were regained postpperatively. Conclution The distal amputated fingers were shoud replantate as far as possible when they were soaked not long and contused not severity, the failure replanted fingers stump were repaired with the reverse fascial pedicle dorsal island flap of finger, it＇ s a pragmatic modus operandi to retain the wound fingers＇ length and function as far as possible.