（足母）甲皮瓣游离移植再造拇指供区的处理

Treatment experience of donor site providing free wrap - around flap used for reconstruction of thumb

目的 探讨（足母）甲皮瓣再造拇指供区的处理方法,再造拇指同时尽量减少供足的并发症和后遗症.方法 在切取（足母）甲皮瓣时将末节趾骨带在皮瓣中,利用保留在供趾胫侧的舌状瓣直接闭合供趾创面,不能直接闭合者则将舌状瓣覆盖供趾跖侧负重面,剩余部分游离植皮.结果 供趾去除末节趾骨者一期愈合,随访3个月～2年,外形稍短,无趾甲,功能恢复满意.结论 去除未节趾骨是避免和减少供趾并发症和后遗症的有效而简便的方法.

Objective To explore the treatment of the donor site providing free wrap - around flap used for reconstruction of the thumb and to relieve the donor＇s sequelae and complication. Methods When harvesting wrap - around flap, reserving the distal phalanx of donor toe, the tongue-like flap remaining in the tibial side of the donor toes closed directly up the wound surface, or it was covered in weight loading area of metatarsal. And the left area was repaired by skingrafting. Results All patients were followed up 3 months to 2 year after operation, the donor toes removing the distal phalanx survived well with good appearances and functions. Conclusion Removing the distal phalanx is a proper option for avoiding and relieving the donor＇s sequelae and complication.