不同皮瓣修复指端软组织缺损疗效对比

Comparison of the Curative Effect of Different Flaps in Repairing Fingertip Soft Tissue Defects

目的对比分析指端侧方转移皮瓣与指动脉逆行岛状皮瓣修复指端软组织缺损的临床效果。方法选取2016年4月至2019年9月常州市新北区奔牛人民医院收治的40例指端软组织缺损患者作为研究对象,并按照治疗方法将其分为观察组与对照组,每组20例。观察组患者行指端侧方转移皮瓣修复,对照组患者行指动脉逆行岛状皮瓣修复,对比两组患者手术时间、术后住院时间、术后拆线时间、并发症发生情况、手指功能恢复情况、移植皮瓣两点辨距觉及患者满意度。结果两组患者术后皮瓣均完全成活,供受区创面均一期愈合,手术时间、术后住院时间、术后拆线时间均无明显差异(t=0.862、0.129、0.464,P=0.394、0.901、0.645)。观察组患者术后并发症发生率为10.0%,对照组患者术后并发症发生率为15.0%,两组间无明显差异(χ^(2)=0.229,P=0.633)。术后6个月,观察组患者中手指功能恢复为优13例、良6例、可1例,与对照组患者中手指功能恢复为优11例、良7例、可2例无明显差异(Z=-0.703,P=0.547),但观察组患者移植皮瓣两点辨距觉明显短于对照组(P=2.727,P=0.010)、患者满意度明显高于对照组(t=3.045,P=0.004)。结论在指端软组织缺损修复中,指端侧方转移皮瓣与指动脉逆行岛状皮瓣均具有良好效果,但指端侧方转移皮瓣对外观及感觉恢复更有优势,患者满意度更高。

Objective To compare and analyze the clinical effect of lateral transposition flaps and reversed digital artery island flap in repairing fingertip soft tissue defects.Methods Forty patients with fingertip soft tissue defects,admitted to Benniu People’s Hospital from April 2016 to September 2019,were selected as study subjects to be divided into an observation group and a control group based on different treatment methods,with 20 cases in each group.Patients in the observation group received the lateral transposition flaps for defect repair,whereas patients in the control group were given the reversed digital artery island flaps.The operation time,postoperative hospital stay,postoperative stitch-removing time,occurrence of complications,finger function recovery,two-point discrimination of transplanted flaps and patient’s satisfaction were compared between the two groups.Results The transplanted flaps of patients were all survived and the wounds on the donor sites all realized primary healing in the two groups.There was no significant difference between the two groups in terms of operation time,postoperative hospital stay,postoperative stitch-removing time(t=0.862,0.129 and 0.464,P=0.394,0.901 and 0.645).The incidence of postoperative complications was 10.0% in the observation group,and 15.0% in the control group,with no significant difference between the two groups(χ^(2)=0.229,P=0.633).Six months postoperation,excellent recovery of finger function was seen in 13 cases,good in 6 cases and fair in one case in the observation group,which showed no statistically significant difference as compared with excellent in 11 cases,good in 7 cases and fair in 2 cases in the control group(Z=-0.703,P=0.547).The two-point discrimination of skin flaps in the observation group was obviously shorter than that in the control group(P=2.727,P=0.010),and the patient’s satisfaction was obviously higher than that in the control group(t=3.045,P=0.004).Conclusion In the repair of fingertip soft tissue defects,both the lateral transposition flap and the reversed digital artery island flap can realize good curative effects,but the lateral transposition flap had more advantages in the recovery of appearance and sensory function,with higher patient’s satisfaction.