“三合一”预制皮瓣移植修复拇指脱套伤的临床应用

Repair of degloved injury of the thumb by"three-in-one"prefabricated flap transplantation

目的总结“三合一”预制皮瓣移植修复拇指脱套伤的临床应用效果。方法2007年1月至2018年1月兰州手足外科医院应用“三合一”预制皮瓣移植修复拇指脱套伤8例。其中,男7例,女1例;年龄22~39岁,平均(32.0±9.6)岁。预制皮瓣的旋股外侧降支血管动脉和静脉分别与桡动脉背侧支动脉和静脉相吻合,供区创面行直接缝合。结果1例供区发生小的切口裂开,经再次缝合后愈合,预制皮瓣全部成活,取得了较满意的效果。术后随访2~5.5年,平均(3.5±1.6)年,供区无明显的功能障碍,受区外形较好。结论“三合一”预制皮瓣移植技术修复拇指脱套伤效果优良,尤其适合不宜行𧿹甲瓣移植手术的拇指脱套伤。

Objective To observe the clinical effects of the repair of degloved injury of the thumb by"three-in-one"prefabricated flap transplantation.Methods Between January 2007 and January 2018,eight patients with degloved injury of the thumb underwent repair by"three-in-one"prefabricated flap transplantation.There were seven males and one female,aged from 22 to 39 years(mean of 32.0±9.6 years).The artery and vein of the descending branch of the lateral circumflex femoral artery of the prefabricated flap were anastomosed to the artery and vein of the dorsal branch of the radial artery,respectively.The wound of the donor site was repaired by direct suture.Results One donor developed small incision dehiscence,but the wound was healed after resuturing.Prefabricated flaps survived completely with satisfactory clinical results.Follow-up period ranged from 2.0 to 5.5 years,mean of(3.5±1.6)years.There was no remarkable function morbidity of the donor site.All cases had good appearance in recipient site.Conclusion This technique has excellent effect for degloved injury of the thumb for which toenail flap transplantation is not suitable.