不同方式的显微外科手术治疗手指皮肤软组织脱套伤

Microsurgical treatment for skin avulsion of the fingers in defferent ways

目的探讨以不同方式的显微外科手术治疗手指皮肤软组织脱套伤及其临床效果。方法应用显微外科技术吻合血管、神经原位再植修复手部皮肤软组织脱套伤19例、应用踇甲皮瓣I期修复拇指脱套伤2例、应用第二趾甲皮瓣I期修复示、中指脱套伤3例。结果术后16例原位再植病例,2例踇甲皮瓣修复病例及3例第二趾甲皮瓣修复病例全部成活;2原位再植病例有小部分坏死,1例原位再植病例完全坏死。成活例病例中22例随访3个月～2年,伤指外形好,血供充分,皮肤质地柔软,伤指感觉及运动功能恢复满意。结论应用不同方式的显微外科手术治疗手指皮肤软组织脱套伤,可最大限度恢复伤指的外形与功能,临床效果良好。

Objective To evaluate the clinical effect of microsurgical treatment for skin avulsion of the fingers in defferent ways. Methods 19 cases with avulsion injury of skin and soft tissue in fingers were treated by microsurgery anastomosing blood vessel and nerves. 2 cases with degloving injury of the thumbs were treated with great toe-nail skin flap, and 3 cases with degloving injury of the index finger and index finger were treated with second toe-nail skin flap. Results 16 cases of replantation in situ were completely alive, and 2 eases were partly alive, 1 case was completely necrotic. All the cases of toe-nail skin flap were completely alive. The cases that were alive after 3 months to 2 years with follow-up, the injuried fingers had good appearance, sufficient blood supply and soft texture. Conclusion Microsurgical treatment for skin avulsion of the fingers in defferent ways shows a good result. The function and appearance of the injuried fingers were satisfactory.