CAJ | 학술논문

目的：比较重建感觉的指动脉背侧支岛状皮瓣与指动脉逆行岛状皮瓣两种手术方法修复指端缺损的效果，为临床选择提供参考。方法自2012年8月～2013年9月，选择本科2～4指甲弧以远的复合组织缺损，指腹单纯软组织缺损者，采用重建感觉的指动脉背侧支逆行岛状皮瓣修复17例（20指）或指动脉逆行岛状皮瓣修复14例（16指），比较手术时间，术后皮瓣情况，随访两组皮瓣两点感觉，受区、供区外观及患指活动度等。结果①指动脉背侧支皮瓣组手术时间平均为78．6min，指动脉皮瓣组45min，两者比较有显著差异（P＜0．01）；②指动脉背侧支皮瓣中有3例（3指）发生血管危象，指动脉皮瓣组中1例（1指）发生静脉回流障碍；③术后12个月时测量两组皮瓣静态两点辨别觉，指动脉背侧支皮瓣组6．2～10．4mm，平均8．3mm，指动脉皮瓣组8．5～12．4mm，平均10．45mm；④指动脉皮瓣组中术后患指怕冷、严寒疼痛现象发生率高于指动脉背侧支组。结论与指动脉岛状皮瓣相比，指动脉背侧支皮瓣可较好地重建指端感觉，应用效果较为满意。
목적：비교중건감각적지동맥배측지도상피판여지동맥역행도상피판량충수술방법수복지단결손적효과，위림상선택제공삼고。방법자2012년8월～2013년9월，선택본과2～4지갑호이원적복합조직결손，지복단순연조직결손자，채용중건감각적지동맥배측지역행도상피판수복17례（20지）혹지동맥역행도상피판수복14례（16지），비교수술시간，술후피판정황，수방량조피판량점감각，수구、공구외관급환지활동도등。결과①지동맥배측지피판조수술시간평균위78．6min，지동맥피판조45min，량자비교유현저차이（P＜0．01）；②지동맥배측지피판중유3례（3지）발생혈관위상，지동맥피판조중1례（1지）발생정맥회류장애；③술후12개월시측량량조피판정태량점변별각，지동맥배측지피판조6．2～10．4mm，평균8．3mm，지동맥피판조8．5～12．4mm，평균10．45mm；④지동맥피판조중술후환지파랭、엄한동통현상발생솔고우지동맥배측지조。결론여지동맥도상피판상비，지동맥배측지피판가교호지중건지단감각，응용효과교위만의。
Objective Providing options for clinicians through compare the effectiveness of reverse island flap pedicled with dor -sal cutaneous branches of digital internal artery with sense reconstruction and reversed digital artery island flap for repairing fingertip soft tis -sue defects.Methods From August 2012 to September 2013,patients with composite tissue defects beyond the lunula or pure pulp soft tissue defects in 2~4 fingers were treated.There were 17 cases(20 fingers) treated with reverse island flap pedicled with dorsal cutaneous branches of digital internal artery with sense reconstruction and 14 cases(16 fingers) treated with reversed digital artery island flap ,then compare the operation time,flap recovery,the two-point discrimination,the norma of donor and recipient sites and the function of trigger finger ,etc.Results①The average operation time ,the group of island flap pedicled with dorsal cutaneous branches of digital internal artery was 78.6 minutes, while the group of digital artery island flap was 45 minutes,there were significant differences between them (P<0.01);②Vascular crisis oc-curred in 4 cases(4 fingers) in island flap pedicled with dorsal cutaneous branches of digital internal artery ,vein drainage disturbance oc-curred in 1 case(1 finger) in eversed digital artery island flap;③After 12 months of operation ,the two-point discrimination of the group of is-land flap pedicled with dorsal cutaneous branches of digital internal artery was 6.2~10.4mm(average,8.3mm),while the group of digital artery island flap was 8.5~12.4mm(average,10.45mm);④The incidence of the phenomenon that finger pain when subjected to cold was higher in roup of island flap pedicled with dorsal cutaneous branches of digital internal artery than the group of digital artery island flap .Con-clusion The island flap pedicled with dorsal cutaneous branches of digital internal artery can reconstruct the perception of finger tip very well and the application effect is satisfactory than the group of digital artery island flap .