同指侧方改良推进皮瓣修复指尖短斜形缺损

Transfer of advanced flap from the same finger to repair short and oblique defects of fingertip

目的探讨同指侧方改良推进皮瓣修复指尖短斜形缺损的手术疗效。方法2007年10月一2010年4月，收治17例指尖呈短斜形缺损伤伴骨外露患者。术中采用1．Ocm×1．8cm-1．2cm×2．0cm同指侧方改良推进皮瓣修复指尖缺损创面。供区取皮瓣远尖端多余皮肤修成全厚皮片回植。结果术后17例皮瓣全部成活，其中14例一期愈合，3例二期愈合。供区植皮成活。术后患者均获6～14个月随访．皮瓣血运良好，质软有弹性，无色素沉着，无臃肿，痛温觉正常，两点辨别觉6-8mm。指体各关节活动无影响，指甲平整。结论同指侧方改良推进皮瓣修复指尖短斜形缺损，解剖恒定，手术简便、安全，术后外形、功能满意，对于指尖甲中1／3及甲远1／3短斜形平面缺损创面的修复可作为优先选择。

Objective To observe the clinical effects of advanced flap from the same finger for repairing the short and oblique defects of fingertip. Methods From October 2007 to April 2010, 17 patients with short and oblique defects of fingertip and bone exposure were treated. There were 11 males and 6 females.The age ranged from 21 to 47. The sizes of the flaps were 1.0cm×1.8cm to 1.2cm×2.0cm.And donor site skin were repaired into full-thickness skin to transplantation. Results The flaps survived in 17 cases, wound healing of 14 cases in stage I , ]I healing in 3 cases. The donor skin-grafting was survival. All the cases were followed up from 6 to 14 months, the flaps had good blood supply, soft and flexible, and normal pain and temperature sensation. And had no pigmentation, fat. The two points discrimination were 6-8mm.It means the body has no effect on the joints, nail formation. Conclusion Transfer of advanced flap from the same finger offered a sensational skin flap for reconstruction short and oblique defects of fingertip. The dissection was constant, the technique was simple, and clinical result was satisfactory. It is an ideal method for repair a fingertip in for 1/3 and a far 1/3 of the short oblique plane wounds.