CAJ | 학술논문

目的：比较拇指桡背侧逆行岛状皮瓣和食指背侧顺行岛状皮瓣修复拇指末节指腹缺损。方法2012年7月～2013年7月，应用拇指桡背侧逆行岛状皮瓣和食指背侧顺行岛状皮瓣修复拇指末节指腹缺损18例，随机分为两组，拇指桡背侧逆行岛状皮瓣组10例，食指背侧顺行岛状皮瓣组8例，术后对皮瓣的成活率、拇指的功能恢复、供区的影响进行了比较研究。结果经11～32个月，平均20个月随访，18例皮瓣成活17例，皮瓣血运、质地良好，仅1例食指背侧顺行岛状皮瓣术后5d皮瓣远端出现部分坏死；皮瓣感觉均恢复到S3，S3＋，其中拇指桡背侧皮瓣组S37例，S3＋3例，食指背侧皮瓣组S33例，S3＋5例。患者拇指再造功能评定为优12例（拇指桡背侧皮瓣组7例，食指背侧皮瓣组5例），良4例（两组各2例），差2例（两组各1例）。结论拇指桡背侧逆行岛状皮瓣修复拇指指腹缺损较食指背侧顺行岛状皮瓣外形美观，血供可靠，对供区影响更小，更适合作为修复拇指末节指腹缺损的选择。
목적：비교무지뇨배측역행도상피판화식지배측순행도상피판수복무지말절지복결손。방법2012년7월～2013년7월，응용무지뇨배측역행도상피판화식지배측순행도상피판수복무지말절지복결손18례，수궤분위량조，무지뇨배측역행도상피판조10례，식지배측순행도상피판조8례，술후대피판적성활솔、무지적공능회복、공구적영향진행료비교연구。결과경11～32개월，평균20개월수방，18례피판성활17례，피판혈운、질지량호，부1례식지배측순행도상피판술후5d피판원단출현부분배사；피판감각균회복도S3，S3＋，기중무지뇨배측피판조S37례，S3＋3례，식지배측피판조S33례，S3＋5례。환자무지재조공능평정위우12례（무지뇨배측피판조7례，식지배측피판조5례），량4례（량조각2례），차2례（량조각1례）。결론무지뇨배측역행도상피판수복무지지복결손교식지배측순행도상피판외형미관，혈공가고，대공구영향경소，경괄합작위수복무지말절지복결손적선택。
Objective To compare the effect of repairing distal thumb defect with thumb radial dorsal retro-grade island skin flap and index finger dorsal anterograde island skin flap .Methods Eighteen cases of patients were cured with two kinds of flaps from 2012 July to 2013 July.They were randomly divided into two groups ,thumb radial dor-sal retrograde flap group contains 10,while index finger dorsal anterograde flap group contains 8.Postoperative survival rate of skin flap,thumb function recovery and the influence to donor site were compared .Results After 11~32 months, average 20 months follow-up,17 in 18 cases survived and showed rich blood supply and good texture ,while only one in-dex finger dorsal anterograde island skin flap was suffered with distal skin flap necrosis .The sensation of the flaps recov-ered to S3,S3+.7 thumb radial dorsal flaps recovered S3,3 cases S3+.3 index finger dorsal flaps recovered S3,5 cases S3+.According to the standard functional evaluation issued by Hand Surgery Association of Chinese Medical Associa -tion,the excellent and good rate was 88.9%.Conclusion The appearance of thumb radial dorsal retrograde island skin flap is more beautiful,blood supply is more reliable,and the influence on the donor area is less .Thumb radial dorsal ret-rograde island skin flap is more suitable for the repair of pulp defect in thumb tip .