指端切割伤断离皮片改良缝合原位再植52指体会

The Experience of the Improved Skin Suture in Situ Replantation Skill in 52 Fingertips of Cutting Injury

目的:介绍指端切割伤断离皮片改良缝合原位再植术的治疗方法、效果和经验总结,分析影响手术疗效的因素。方法:对37例52指指端切割伤断离皮片行改良缝合原位再植.术后随访1～24个月。结果:术后各型指端切割伤断离皮片成活率分别为:Ⅰ型94.7%;Ⅱ型88.2%;Ⅲ68.8%。在指端切割伤断离皮片改良缝合原位再植术式中,其操作简便,疗效确切,虽存在一定的失败风险,但不失为一种积极的治疗方法。结论:只要切割伤离断的皮片仍较完整,而无手术禁忌证,均可予以改良缝合原位再植。彻底的清创、消毒及所植皮片均匀稳定受压、牢固固定,加上感染的预防是成功的关键。

Objective：To introduce the therapeutic methods and curative effect,as well as the experience of the improved suture in situ replantation in cutting injury of fingertips and analyze the factors that affect the clinical therapeutic effectiveness.Methods：The 52 fingertips with cutting injury of 37 cases have been treated with the improved suture in situ replantation.The postoperative follow-up period was from 1～24 months.Results：The survival rate of different types：94.7% in typeⅠ;88.2% in typeⅡ;68.8% in type Ⅲ.In spite of some risks of failure,this therapeutic method is still an positive treatment for its simplicity,convenience and curative effect.Conclusion：Fingertips of cutting injury could be replanted as long as the cutting skin remains relatively integrated,and there are no surgical contraindications.Keys to success include thorough debridement,sterilization,even pressure on the cutting skin,firm attachment after grafting and successful infection prevention.