显微回植修复兔模型前足皮肤脱套伤的研究

Experimental study on micro replantation repair of rabbit model of the foot skin degloving injury

目的 探讨在显微镜下回植皮肤,修复兔模型前足皮肤脱套伤的应用效果.方法 选择新西兰大白兔48只,通过装置模拟利器切割撕脱、重物挤压前足等场景,造成大白兔前足脱套伤合并胫骨、跖骨、指（趾）骨骨折等,建立大白兔前足皮肤脱套伤的动物模型,成功41只,并采用内固定趾骨或胫骨骨折,在显微镜下修复断裂肌腱,吻合前足断裂的动脉及相应神经,并将背侧皮肤向远侧掀起,通过直接吻合、转位吻合、移植桥接等方法,逐平面的吻合背侧的动静脉,使皮肤复位,至创缘时吻合创缘皮下浅静脉,缝合皮缘,并放置橡皮引流条.术后石膏固定兔模型前足,抗炎抗感染.结果 41只兔模型回植的皮肤全部成活,3只兔模型创缘皮肤部分坏死,经换药创面愈合.术后X线复查,趾骨胫骨骨折对位好.对兔模型随访3～9个月,平均5个月,骨折和皮肤创面愈合良好,前足可正常行走.结论 在显微镜下回植皮肤,修复兔模型的前足皮肤脱套伤,有效恢复了伤足的供血,加速了骨折的愈合,可有效恢复大白兔模型伤是的行走功能.

Objective To investigate the replanting the skin under the microscope,the repair of rabbit model of anterior foot application effect of skin degloving injury.Methods 48 New Zealand rabbits,by means of simulation tool cutting avulsion,crush fore foot scene,resulting in the big white rabbit forefoot degloving injury combined with tibia,metatarsal,finger （toe） bone fracture,the establishment of rabbit animal model of the foot skin degloved injury,41 cases were successful,and the use of internal fixation of tibial fracture phalanx or repair of tendon rupture,under the microscope,the artery anastomosis front foot fractureand corresponding nerve,the dorsal skin and set off to the far side,through the direct anastomosis,anastomosed graft bridging method,such asby plane,arteriovenous anastomosis of dorsal,enable the skin to reset,a margin of time a margin of superficial vein anastomosis suture,skin edge,and placed the rubber drainage.Postoperative plaster fixation of rabbit model of the front foot,anti-inflammatory,anti infection.Results 41 cases of rabbit model of skin replantation survived,3cases of wound edge skin a rabbit model of partial necrosis and healed by dressing.Postoperative X-ray review,phalanxtibial fractures of good.The rabbit models were followed up for 3-9 months,average 5 months,fractureand skin wound healed well,the front foot can walk normally.Conclusion In the microscopenext planting the skin,the foot skin repair of degloving injury of the rabbit model,effectively restore the injured foot blood supply,accelerate the healing of fractures,walking function can effectively restore the injured foot in rabbit model.