邻指皮瓣与鱼际皮瓣在手指皮肤软组织缺失修复中的应用对比

Application comparison of adjacent finger flap and fish skin flap in the repair of finger skin soft tissue loss

目的对比邻指皮瓣与鱼际皮瓣在手指皮肤软组织缺失修复中的应用效果。方法选择手指皮肤软组织缺失患者114例,根据随机数字表法分为观察组与对照组,各57例。观察组予鱼际皮瓣治疗,对照组予邻指皮瓣治疗,记录与随访2组的预后。结果患者均顺利完成手术,观察组创面愈合时间、术后换药次数、上皮组织完全覆盖创面时间与住院时间显著少于对照组(P<0.05)。术后3个月观察组创面感染、创面坏死、瘢痕挛缩、静脉危象等并发症发生率显著低于对照组(P<0.05)。术后3个月观察组总有效率(98.2%,56/57)显著高于对照组的(87.7%,50/57)(P<0.05)。术后随访1年,观察组的感觉恢复功能情况显著好于对照组(P<0.05)。结论相对于邻指皮瓣,鱼际皮瓣在手指皮肤软组织缺失修复中的应用能促进患者的创面愈合,提高治疗效果,减少并发症的发生,加快恢复患者的手指感觉功能。

Objective To compare the application effect of adjacent finger flap and thenar flap in the repair of finger skin soft tissue loss.Methods From May 2016 to July 2018,114 patients with finger skin soft tissue loss in our hospital were selected as the subjects and randomly divided into observation group and control group according to the random number table method.The observation group was treated with fish skin flap,and the control group was treated with cross finger flap.The prognosis of two groups were recorded and followed up.Results All the patients successfully completed the operation.The wound healing time,postoperative dressing changes,epithelial tissue completely covering the wound and hospital stay in the observation group were significantly shorter or less than those in the control group (P<0.05).The incidence of wound infection,wound necrosis,scar contracture,venous crisis and other complications was 3.5% in the observation group 3 months after operation,which was significantly lower than that in the control group (17.5%) (P<0.05).The total effective rate of the observation group 3 months after surgery was 98.2%,significantly higher than the control group (87.7%) (P<0.05).After one-year follow-ups,the sensory function recovery of the observation group was significantly better than that of the control group (P<0.05).Conclusion Compared with adjacent finger flap,the application of thenar flap in the repair of finger skin soft tissue loss can promote the wound healing,improve the therapeutic effect,reduce the incidence of complications,and accelerate the recovery of finger sensory function.