皮瓣移植修复治疗手外伤组织缺损的临床治疗效果

The clinical effect of skin flap transplantation on traumatic tissue defect in hand

目的:研究皮瓣移植修复治疗手外伤组织缺损的临床治疗效果。方法:选择2006年1月至2016年12月诊治的手外伤组织缺损患者180例,均采取皮瓣移植修复治疗。记录患者的皮瓣来源情况,观察患者采取皮瓣移植修复治疗后的修复创面效果,随访半年记录患者对外形和功能恢复的满意情况。结果:180例手外伤组织缺损患者的皮瓣来源情况由高到低依次为腹部带蒂皮瓣(28.87%)、锁骨下带蒂皮瓣(25.52%)、环指桡侧和中指尺侧岛状皮瓣(22.78%)、V-Y皮瓣(11.67%)、手掌背动脉逆行岛状皮瓣(7.22%)、食指近节背侧岛状皮瓣(2.22%)、足背复合组织游离皮瓣(1.67%);180例手外伤组织缺损患者采取皮瓣移植修复治疗后,177例患者的皮瓣全部成活,且均属于创面Ⅰ期愈合,3例患者发生皮瓣小面积坏死,采取换药处理后创面成功愈合出院;随访半年后发现共有153例患者对外形及功能恢复满意,总满意率为85.0%。结论:皮瓣移植修复治疗手外伤组织缺损具有较好的临床治疗效果,值得应用推广。

Objective： To study the clinical effect of skin flap transplantation on traumatic tissue defect in hand. Methods： 180 patients with traumatic tissue defect in hand hospitalized from January 2006 to December 2016 who were treated with skin flap transplantation were chosen,with the flap sources recorded and the wound healing effect after skin flap transplantation observed. The patients were followed up for half a year,with the patient＇s satisfaction with the appearance and functional recovery recorded. Results： The flap sources of 180 patients with tissue defect of hand injury are abdominal pedicle flaps,accounting for 28. 87%,subclavian pedicled flaps,accounting for 25. 52 %,ring finger radial and middle finger ulnar island flaps,accounting for 22. 78 %,V-Y flaps,accounting for 11. 67 %,palmar dorsal artery retrograde island flaps,accounting for7. 22 %,index finger proximal dorsal island flaps,accounting for 2. 22 % and the dorsal foot complex flaps,accounting for 1. 67 %. In 180 patients with traumatic tissue defect in hand who were treated with skin flap transplantation,177 patients＇ flaps all survived,which all belonged to the primary healing and 3 patients suffered from small flap necrosis but discharged after dressing change and wound healing. After half a year＇s follow-up,a total of 153 patients were satisfied with the appearance and function recovery,accounting for 85. 00 % of the total. Conclusion： Skin flap transplantation has a good clinical effect on traumatic tissue defect in hand and is worth promoting.