拇甲瓣供区创面修复的临床体会

Clinical experience of great toe-nail flap donor site wound repair

目的:探讨拇甲瓣供区创面修复的方法。方法:回顾性分析2007年8月～2012年3月收治的45例游离拇甲瓣再造拇(手)指患者。根据供足创面不同的修复方法分三组:A组21例,适当咬除趾骨,直接缝合供区;B组16例,第1跖背动脉皮瓣修复;C组8例,采用跗外侧动脉皮瓣修复。结果:45例患者均获得随访,随访时间6～24个月,平均11个月。A组2例因缝合张力大,远端创缘部分皮肤坏死;B组、C组皮瓣全部成活。5例患者对外形不太满意,其余患者对外形及功能均较满意。结论:根据拇甲瓣供区创面大小及患者个性化要求,选择适合方法修复,能达到较好的临床效果。

Objective To explore method of donor repair of the great toe-nail flap. Methods Methods a retrospective analysis of 2007 August to 2012 March,45 cases of free great toe-nail flap for reconstruction of the thumb （finger） patients. According to the donor foot wounds of different reconstructive methods are divided into three groups：21 cases in group A, the appropriate bit in addition to the phalanx, direct suture for the district;16 cases in group B, first dorsal metatarsal artery flap to repair;8 cases in C group, the lateral tarsal artery flap. Results 45 cases were followed up, follow-up time of 6 months to 24 months, mean 11 months. 2 cases in A group because of suture tension, the distal end of a margin of partial skin necrosis; group B, group C all flaps survived. In 5 patients the appearance were less satisfied with the appearance and function, the remaining patients were satisfied. Conclusion According to the great toe-nail flap donor site wound size and patient individual requirements, to choose a suitable method of repair, can achieve good clinical effect.