改良指背神经营养皮瓣修复手指远端皮肤软组织缺损的临床研究

Clinical study of modified skin flap nourished by dorsal digital nerves for the repair of distal finger skin and soft tissue defect

目的探讨采用改良指背神经营养皮瓣修复手指远端皮肤软组织缺损的临床疗效。方法对25例(29指)手指远端皮肤软组织缺损患者行改良指背神经营养皮瓣修复治疗,缺损面积为0.8 cm×1.2 cm^2.5 cm×4.0 cm,观察术后治疗效果。结果 25例患者中皮瓣成活24例,成活率达96.00%,1例切口感染,5例皮瓣臃肿,给予适当药物治疗后均痊愈,术后随访(9.34±0.23)个月,皮瓣色泽红润,血运良好,质地柔软,弹性好,供区愈合较好,无明显色素沉着,基本留取了指体长度与外形,皮瓣感觉明显改善,两点辨别觉4.5~7.0 mm。结论改良指背神经营养皮瓣修复手指远端皮肤软组织缺损临床疗效确切,安全指数高。

Objective To explore the clinical efficacy of modified skin flap nourished by dorsal digital nerves for the repair of distal finger skin and soft tissue defect. Methods Modified skin flap nourished by dorsal digital nerves was used in 25 patients （29 fingers） with distal finger skin and soft tissue defect. The size of skin and soft tissue defect was 0. 8 cm × 1.2 cm to 2. 5 cm × 4. 0 cm. The efficacy was evaluated postoperatively. Results Of the 25 cases, there were 24 eases with skin flap survival, and the survival rate was 96.00%. Incision infection occurred in one case, and bloated skin flaps were observed in 5 cases. However, these six patients recovered after appropriate medication administration. The postoperative follow-up duration was （9.34± 0.23 ） months. The appearance of skin flaps was red and glossy in all of the eases. All of the skin flaps were soft and elastic, and had good blood supply. The skin donor sites healed well. No obvious pigmentation was observed, and the normal length and appearance of fingers were preserved. The sensation of skin flaps was obviously improved. The two-point discrimination was 4. 5 to 7. 0 mm. Conclusions Repair with modified skin flap nourished by dorsal digital nerves earl provide exact efficacy and high safety for patients with distal finger skin and soft tissue defect.