人工真皮修复手指甲床缺损的应用及疗效

Clinical application and outcomes of artificial dermis in repair of nail bed defects

目的探讨并分析应用人工真皮修复手指甲床组织缺损的临床应用及疗效。方法自2017年1月至2020年12月我科应用人工真皮修复手指甲床组织缺损25例25指,其中拇指6指、示指8指、中指6指、环指4指、小指1指。术后1个月拆除整个人工真皮,随访观察甲床再生和指甲板生长情况以及手功能恢复情况。结果术后随访6~22个月,平均13个月,所有病例手指甲床再次生长覆盖原有创面,指甲生长平滑光整、匀称坚硬,指甲板与甲床附着良好。患者对术后指甲生长满意度:非常满意24例,满意1例。根据Wang-Gao的指甲评定标准进行评价:优22例,良3例;优良率100%。结论人工真皮修复手指甲床缺损疗效满意,操作简单,损伤小,是一种治疗手指甲床缺损的安全可靠的修复方法。

Objective To explore and analyze the clinical application and efficacy of artificial dermis in repair of nail bed defects.Methods From January 2017 to December 2020,25 fingers of 25 cases of nail bed tissue defects were repaired with artificial dermis in our department,including 6 thumbs,8 index fingers,6 middle fingers,4 ring fingers and 1 little finger.One month after operation,the whole artificial dermis was removed,and the regeneration of nail bed,the growth of nail plate and the recovery of hand function were observed.Results All the cases were follow-up for 6 to 22 months,with an average of 13 months.The nail bed grew again and covered the original wound.The nail grew smoothly,symmetrical and hard,and the nail plate attached well to the nail bed.The patients′satisfaction with postoperative nail growth was very satisfied in 24 cases and satisfied in 1 case.According to Wang-Gao nail evaluation criteria,the results were rated as excellent in 22 cases,good in 3 cases.The excellent and good rate was 100%.Conclusion The artificial dermis is a safe and reliable method to repair the defects of nail bed with satisfactory clinical efficacy,simple operation and little damage.