CAJ | 학술논문

目的探讨第二足趾与足背三叶皮瓣复合移植修复拇指及手部皮肤缺损的临床疗效.方法 2010年6月至2013年3月,对6例拇指残端、掌背侧及虎口部皮肤缺损,合并肌腱、骨及神经血管外露的患者,采用第二足趾与足背三叶皮瓣复合移植修复.结果术后跗外侧皮瓣、跗内侧皮瓣、足背皮瓣及第二足趾均存活,供受区切口均工期愈合.所有患者均获得3～ 18个月的随访,平均8个月,皮瓣色泽、质地、外形均良好,再造指功能可.患足负重行走正常,皮瓣供区无溃疡.结论胫前动脉为血管蒂的三叶皮瓣联合第二足趾移植修复不规则组织缺损的拇指,血供可靠,修复充分,符合创伤修复原则.
목적 탐토제이족지여족배삼협피판복합이식수복무지급수부피부결손적림상료효.방법 2010년6월지2013년3월,대6례무지잔단、장배측급호구부피부결손,합병기건、골급신경혈관외로적환자,채용제이족지여족배삼협피판복합이식수복.결과 술후부외측피판、부내측피판、족배피판급제이족지균존활,공수구절구균공기유합.소유환자균획득3～ 18개월적수방,평균8개월,피판색택、질지、외형균량호,재조지공능가.환족부중행주정상,피판공구무궤양.결론 경전동맥위혈관체적삼협피판연합제이족지이식수복불규칙조직결손적무지,혈공가고,수복충분,부합창상수복원칙.
Objective To investigate the clinical outcomes of treating irregular tissue defect of the thumb and hand with composite transfer of the second toe and dorsal pedal trilobe flap.Methods From June 2010 to March 2013,6 cases of thumb injury with various degrees of thumb defect,skin defect at the palm,dorsum and web space,and exposure of tendon,bone and neurovascular structures were treated with composite transfer of the second toe and dorsal pedal trilobe flap.Results The trilobe flaps including the lateral tarsal flap,medial tarsal flap,dorsalis pedis flap all survived uneventfully.The transferred second toes survived as well.Wounds at the donor and recipient sites all achieved primary healing.The patients were follow-up for 3 to 18 months with an average period of 8 months.The shape,color and texture of the flaps were good.Function of the reconstructed thumb was satisfactory.Weight-bearing and walking with the donor foot was not affected.There was no ulcer in the flap donor site.Conclusion Combined transfer of dorsal pedal trilobe flap based on the anterior tibial artery vascular pedicle and the second can effectively reconstruct thumb defects complicated by irregular tissue loss.This method provides sufficient tissue coverage and reliable blood supply.It complies with principles of wound repair.