游离腹股沟皮瓣修复拇指环形电烧伤的临床研究

Clinical study of free groin flap in repairing circular electric burn in thumb

目的观察游离腹股沟皮瓣修复拇指环形电烧伤的效果。方法选取2014年6月至2020年2月郑州市第一人民医院烧伤科收治的20例拇指环形电烧伤患者为研究对象,所有患者拇指创面彻底清创后,I期采用游离腹股沟皮瓣进行修复,术后给予抗凝、抗感染、抗血管痉挛等综合治疗。术后1周和2周分别统计皮瓣存活率及创面Ⅰ期愈合率;术后6个月评价皮瓣外观、拇指运动功能及皮瓣感觉功能。结果20例患者术后皮瓣成活率及创面Ⅰ期愈合率均为100.00%。皮瓣外观、质地良好,优良率为95%(19/20)。拇指功能评定综合评价:优10例,良8例,中2例,优良率90%。其中10例患者拇指可以完成对指以及拇指关节自主活动度超90°。皮瓣两点辨别觉为(8.2±1.4)mm,皮瓣感觉恢复良好。结论游离腹股沟皮瓣修复拇指环形电烧伤外形美观,供区隐蔽,术后拇指功能恢复好,可以作为修复拇指环形软组织缺损的一种皮瓣选择。

Objective To observe the effect of free groin flap in repairing circular electric burn in thumb.Methods From June 2014 to February 2020,20 patients with circular electrical burn of thumb treated in Department of Burns,First People′s Hospital of Zhengzhou were selected as research object.After complete debridement of the thumb wound,the free groin flap was used to repair the wound in stage I.All patients were treated with anticoagulation,anti-infection,anti-vasospasm and other comprehensive treatment after operation.The survival rate of the flap and the primary healing rate of the wound were observed at 1 week and 2 weeks after operation,and the appearance of the flap,thumb movement and sensory function were evaluated at 6 months after operation.Results In 20 patients,the survival rate of skin flap and the primary healing rate of wound were 100.00%.The skin flap had good appearance and texture,and the excellent and good rate was 95%(19/20).Comprehensive evaluation of hand function:excellent in 10 cases,good in 8 cases,fair in 2 cases,excellent and good rate of 90°,among which the thumb of 10 patients could complete finger alignment and autonomic motion of the thumb joint could move more than 90.The two-point discrimination of the flap was(8.2±1.4)mm.The recovery of sensory function of flap was good.Conclusions The free groin flap can be used as a choice for repairing circular soft tissue defect of thumb because of its beautiful appearance,concealed donor area and good recovery of thumb function after operation.