双侧带足趾趾蹼的足背皮瓣组合移植治疗全手皮肤套状撕脱伤

Combined implantation of bilateral dorsalis pedis flap with toe web space on treatment of the skin degloving injury in the hands

目的 介绍用组织瓣组合移植治疗全手皮肤套状撕脱伤的方法。方法 采用双侧带足趾、趾蹼的足背皮瓣组合移植修复 6例全手皮肤套状撕脱伤 ,并再造拇指和中、环指 ;足背皮瓣修复手掌及手背部的皮肤缺损 ,趾蹼皮瓣重建虎口。结果 6例所有的组织瓣全部成活。术后随访 1～ 3年 ,所有伤手外形尚好 ,虎口开大如健侧 ,拇、中环指能对指、对捏 ;指腹二点分辨觉为 6～ 9mm。结论 带双侧足背和趾蹼皮瓣的足趾游离移植是治疗全手皮肤套状撕脱伤的良好方法。

Objective To introduce a new method of combined implantation for treatment of skin degloving injury in the hand.Methods 6 cases of skin degloving injury in the hands were repaired by combined implantation of bilateral dorsalis peids flap with toe web space. Reconstruction of thumb , middle and ring finger was done simultaneously. The skin defect of hand at the palm and dorsal sides were repaired by the dorsalis pedis flap,and the first web by toe web space. Results Six cases were obtained successful results .Over 1 to 3 years period of follow up,the appearance of hands was satisfactory, with a comparable size of the first web as the unaffected side. Pinch between thumb and middle and ring finger functioned well. The 2 PD was achieved 6 to 9 mm. Conclusions Free toe implantation with double dorsalis pedis flap with toe web space is a good approach in treatment of the skin degloving injury in the hand.