食指背侧岛状皮瓣修复拇指软组织缺损32例临床观察

Clinical observation of 32 cases of forefinger dorsal island flap repair for thumb soft tissue defect

目的探讨食指背侧岛状皮瓣修复拇指软组织缺损的临床效果。方法 32例应用食指背侧岛状皮瓣修复拇指软组织缺损患者,对其手术方法、治疗结果及经验进行总结分析。结果 32例患者均顺利完成手术,手术时间65-90 min,平均手术时间74.9 min,术后平均住院时间11.7 d。32例皮瓣中,4例出现远端部分坏死,经换药后创面愈合,其余皮瓣均全部成活。随访6个月-3年,皮瓣皮肤感觉恢复,质薄耐磨,外形美观。植皮全部成活,拇、食指各关节活动不受限。结论食指背侧岛状皮瓣修复拇指软组织缺损操作简便、术后手背外观较好、远期食指外观及色泽均满意,功能良好。

Objective To investigate the clinical effect of forefinger dorsal island flap repair for thumb soft tissue defect. Methods There were 32 cases undergone forefinger dorsal island flap repair for thumb soft tissue defect, and the curative effects and experience were summarized and analyzed. Results All the 32 cases were successfully operated, and the operation time was 65-90 rain with an average time of 74.9 mira, and the average postoperative hospital stays was 11.7 d. Among the 32 cases of flap, there were 4 distal partial necrosis cases, while the wound healed after dressing change. The other flaps all survived. After Follow-up for 6 months to 3 years, the transfer of skin flap sensory recovered, quality of the flap was thin and abrasion resistant, and the appearance was good. Skin grafts all survived, and activities of each thumb and forefinger joints were not restricted. Conclusion The forefinger dorsal island flap repair for thumb soft tissue defect is easy to operate, and postoperative appearance of opisthenar is good. The Forward appearance and color of forefinger are satisfying with, and it functions well.