第二趾趾端复合组织串联趾侧方皮瓣修复指端缺损

Second Toe-tip Composite Tissue combined with Lateral Toe Flap Transfer in Repairing Fingertip Defects

目的对采用第二趾趾端复合组织串联趾侧方皮瓣修复指端缺损的临床效果进行观察和探讨。方法选择我院2009年9月至2011年9月收治的23例指端缺损患者作为观察对象,设计以趾底动脉-甲皱襞血管筋膜蒂为血管蒂的第二趾趾端复合组织,串联趾侧方皮瓣进行修复。结果经过3个月至18个月的随访,23例患者皮瓣均存活,患者手指功能恢复均良好,外观恢复满意,色素沉着不明显;患者供区趾甲恢复满意,未出现疼痛,侧方皮瓣供区植皮均存活,未发生破溃现象。结论应用第二趾趾端复合组织串联趾侧方皮瓣修复指端缺损,具有不影响足趾,微创手术创伤小,手术操作时间短,术后患指感觉、功能、外形恢复理想的优点,适用于临床上指端缺损的修复。

Objective To observe and discuss the clinical effects of the second toe-tip composite tissue combined with lateral toe flap transfer in repairing fingertip defects. Methods 23 patients with fingertip defects admitted to our hospital from September 2009 to September 2011 were chosen as observation object. Second toe-tip composite tissue was designed based on the proper toe artery and the nail fold fascial-vascular pedicel and then used for fingertip repairing in combination with lateral toe flap. Results After following up for 3 months to 18 months,23 cases of flap survived. Patients had fine finger functional recovery with satisfactory appearance and unobvious pigmentation. The donor toes had normal nail growth without the occurrence of pain. Side flap skin grafts survived without ulceration. Conclusion Second toe-tip composite tissue combined with lateral toe flap, in repairing fingertip defects,is a minimally invasive procedure with short operation time, which brings satisfactory appearance and good functional recovery for patients. Thus, it is suitable for clinical repairing of fingertip defects.