包埋皮瓣修复联合湿润烧伤膏治疗末节毁损性离断的效果观察

CLINICAL EFFICACY OF DESTRUCTIVE AMPUTATION OF DISTAL SEGMENT OF FINGER BY BURIED FLAP REPAIR COMBINED WITH MOIST EXPOSED BURN OINTMENT

目的探究包埋皮瓣修复联合湿润烧伤膏治疗末节毁损性离断的效果观察。方法回顾性分析2008年1月—2013年12月在该院治疗的手指末节毁损性离断患者156例175指[男89例(95指),女67例(80指)]作为研究对象,根据随机数字表法将156例患者随机平均分为二组,观察组78例(87指),行包埋皮瓣修复联合湿润烧伤膏法;对照组78例(88指),行包埋皮瓣修复法。观察术后4周二组患者离断指皮瓣优良率;术后6个月二组患者关节总主动活动度、指甲再生、钩甲畸形、感染等指标。结果术后4周二组患者离断指皮瓣优良率及优秀率差异无统计学意义(P>0.05),均较为理想;术后6个月观察组手指功能及指甲再生总优良率分别为89.7%(78/87)、95.4%(83/87)显著高于对照组的67.0%(59/88)、75.0%(66/88)(P<0.05),此外观察组感染率及钩甲畸形分别为3.4%(3/87)、3.4%(3/87)明显低于对照组的19.3%(17/88)、22.7%(20/88)(P<0.05)。结论包埋皮瓣修复联合湿润烧伤膏治疗末节毁损性离断与传统手段相似,方法简单,安全,临床效果明显,术后皮瓣存活、手指活动功能、指甲再生等方面均较为理想,具有较高的临床价值。

Objective To explore the effect of the buried flap repair combined with moist burn cream in the treatment for the destructive severed terminal phalanx. Methods Clinical data of 156 cases of the destructively severed terminal phalanx in authors hospital from January 2008 to December 2013 were analyzed retrospectively, including 89 male cases （95 lesions） and 67 female cases （80 lesions）. According to the random number method, they were randomly divided into two groups. The experimental group with 78 cases （87 lesions） were treated with buried flap repair method combined with moist burn cream. While the control group with 78 cases （88 lesions） were treated with the buried flap repair method. The fine rate of the severed finger flap after 4 weeks, the total active motion of joints, the regeneration of nails, hook a malformation, infection and so on were observed after 6 months in two groups. Results The fine rate and the excellent rate of the severed finger flap both had no significant difference （P〉0.05） after 4 weeks, and their effects were ideal; The total fine rates of the finger function and nails regeneration in the experimental group after 6 months were 89.7% （78/87） and 95.4% （83/87）, which was significantly higher than those in the control group （67.0% （59/88）, 75.0% （66/88）） （P〈0.05）. In addition, the rate of infection and architecture deformity of the experimental group were 3.4% （3/87） and 3.4% （3/87）, which were significantly lower than those of the control group （19.3%（17/88） and 19.3% （20/88）） （P〈0.05）. Conclusion It＇s similar to traditional methods to treat the destructively severed terminal phalanx with the buried flap repair method combined with moist burn cream that has high clinical value because the method is simple and safe, clinical effect is obvious and postoperative flap survival, finger activity function and nails regeneration are all ideal.