CAJ | 학술논문

目的探讨应用组合组织移植修复全手皮肤套脱伤的方法.方法对3例全手皮肤套脱伤患者,分别采用一侧足部以胫前动脉为蒂的带踝前皮瓣、足背皮瓣、足内侧皮瓣和足外侧皮瓣的拇甲皮瓣再造拇指,修复桡侧手掌手背及虎口区皮肤缺损;另一侧足部带以上相同皮瓣的第二趾甲皮瓣再造示指(或中指),修复尺侧手掌及手背皮肤缺损.结果术后3例,除一再造示指坏死外,其余组织瓣全部存活.术后随访3～12个月,修复后手部外形和捏、握、抓等功能基本恢复.皮瓣及再造拇、示指(或中指)感觉恢复至S2～S4.结论双足带有同蒂多叶皮瓣的趾甲皮瓣移植治疗全手皮肤套脱伤是一种有效的治疗方法.
목적 탐토응용조합조직이식수복전수피부투탈상적방법.방법 대3례전수피부투탈상환자,분별채용일측족부이경전동맥위체적대과전피판、족배피판、족내측피판화족외측피판적무갑피판재조무지,수복뇨측수장수배급호구구피부결손;령일측족부대이상상동피판적제이지갑피판재조시지(혹중지),수복척측수장급수배피부결손.결과 술후3례,제일재조시지배사외,기여조직판전부존활.술후수방3～12개월,수복후수부외형화날、악、조등공능기본회복.피판급재조무、시지(혹중지)감각회복지S2～S4.결론 쌍족대유동체다협피판적지갑피판이식치료전수피부투탈상시일충유효적치료방법.
Objective To explore a new operative method of repairing degloving injury of the entire hand by composite transfer.Methods A total of 3 cases of hand degloving injuries were treated with flap transfers from bothfeet.Wrap-around flap from one foot combined with anterior ankle flap,dorsal pedal,medial pedal and lateral pedal flaps all based on the anterior tibial artery were transferred to reconstruct the thumb and cover skin defects of the web space and the thumb and radial side of the hand.The second toe combined with abovementioned pedal flaps were harvested from the other foot and transferred to reconstruct the index or middle finger and cover skin defects on the ulnar side of the hand.Results All the skin flaps survived postoperatively,except necrosis of a reconstructed index finger.Follow up ranged from 3 to 12 months.The appearance of the hand and functions such as pinch.grasp and grip recovered essentially.The sensation of the flaps and reconstructed digits returned to S2 to S4.Conclusion Combined transfer of wrap-around flap and multi-petal flaps based on one pedicle from both feet is an effective way to repair degloving injury of the entire hand.