前臂游离静脉皮瓣桥接重建血液循环并覆盖缺损创面在指体及组织块离断再植中的临床效果

Clinical effect of the forearm free-flap bridging reconstruction for restoring blood circulation and covering the defect wound in finger and tissue block replantation

目的探讨前臂游离静脉皮瓣桥接重建血液循环并覆盖缺损创面在指体及组织块离断再植中的临床效果。方法选取2019年1月至2021年1月泉州仁福骨外科医院收治的100例指体及组织块离断患者作为研究对象,采用随机数字表法分为研究组与对照组,每组50例。研究组接受前臂游离静脉皮瓣桥接重建血液循环并覆盖缺损创面,对照组接受前臂远端掌侧动脉化静脉皮瓣修复,比较两组围术期指标、手术前后总主动活动度(TAM)评分、临床疗效及并发症发生率。结果两组手术时间比较差异无统计学意义;研究组术中出血量少于对照组,住院时间及术后皮瓣愈合时间均短于对照组,差异有统计学意义(P<0.05)。术后1、3、6个月,两组TAM评分均高于前一时间点,且研究组高于对照组,差异有统计学意义(P<0.05)。研究组优良率高于对照组(96.00%vs.80.00%),差异有统计学意义(P<0.05)。研究并发症发生率低于对照组(2.00%vs.16.00%),差异有统计学意义(P<0.05)。结论前臂游离静脉皮瓣桥接重建血液循环并覆盖缺损创面在指体及组织块离断再植中应用效果显著,皮瓣存活率高,且并发症少,可有效改善患者手功能,促进患者尽快康复。

Objective To explore the clinical effectiveness of forearm free-flap bridging reconstruction for restoring blood circulation and cover-ing the defect wound in finger and tissue block replantation.Methods A total of 100 patients with finger and tissue block detachment treated in Quanzhou Renfu Orthopedic Hospital from January 2019 to January 2021 were selected as the study subjects,they were divided into the study group and the control group by random number table method,with 50 cases in each group.The study group underwent forearm free-flap bridging recon-struction for blood circulation and defect wound coverage,while the control group underwent forearm distal palmar side arterialized venous flap re-pair,the perioperative indicators,total active motion(TAM)scores before and after operation,clinical efficacy and complication rates were compared between the two groups.Results There was no statistically significant difference in the duration of surgery between the two groups;the amount of intraoperative blood loss in the study group was less than that in the control group,and the hospitalization time,and faster flap healing time were shorter than those in the control group,the differences were statistically significant(P<0.05).At 1,3,and 6 months after surgery,TAM scores of the two groups were higher than those at the previous time point,and the study group were higher than the control group,and the differences were statis-tically significant(P<0.05).The excellent and good rate in the study group was higher than that in the control group(96.00%vs.80.00%),and the difference was statistically significant(P<0.05).The incidence of complications in the study group was lower than that in the control group(2.00%vs.16.00%),and the difference was statistically significant(P<0.05).Conclusion Forearm free-flap bridging reconstruction for restoring blood cir-culation and covering the defect wound in finger and tissue block replantation demonstrates has significant clinical efficacy,the flap survival rate is high,and few complications,can effectively improving the hand function of patients and promoting rapid recovery as soon as possible.