CAJ | 학술논문

目的：探讨指背筋膜蒂皮瓣修复手指皮肤缺损的临床疗效。方法2011年10月-2013年2月收治手指皮肤及软组织缺损患者33例（37指），男19例（22指），女14例（15指）；受伤至入院时间1 h～15 d；指腹皮肤缺损17指，甲床缺损9指，中节掌侧皮肤缺损6指，中远节掌侧皮肤缺损5指；皮瓣切取面积0悙．8 cm ×1．0 cm～1．9 cm ×2．7 cm。应用大小为1．0 cm ×1．2 cm ～2．1 cm ×2．9 cm的指背筋膜蒂皮瓣修复创面，供区游离植皮修复。根据患指缺损形状、大小、在指背设计皮瓣，自手指近端游离皮瓣，远端设计为“泪滴”状。皮瓣与受区疏松缝合，放置引流片，供区近节指背采用全厚皮片植皮修复。术后抗炎抗痉挛等常规治疗。结果术后5例皮瓣远端出现张力性水疱，经换药后愈合；其余皮瓣及供区植皮均顺利成活，创面均I期愈合。术后30例（34指）获随访，随访时间6～25个月，中位数16．8个月。皮瓣质地柔软，外观饱满。术后6个月皮瓣两点辨别觉为6～9 mm，中位数7．7 mm。手功能按手指总主动活动度评分法评定达105°～230°，中位数204．6°。结论指背筋膜蒂皮瓣修复手指皮肤缺损创伤小，手术操作简单，可以早期功能锻炼；术后皮瓣厚薄、质地良好，皮瓣可恢复感觉，是一种修复手指皮肤缺损的好方法。
목적：탐토지배근막체피판수복수지피부결손적림상료효。방법2011년10월-2013년2월수치수지피부급연조직결손환자33례（37지），남19례（22지），녀14례（15지）；수상지입원시간1 h～15 d；지복피부결손17지，갑상결손9지，중절장측피부결손6지，중원절장측피부결손5지；피판절취면적0형．8 cm ×1．0 cm～1．9 cm ×2．7 cm。응용대소위1．0 cm ×1．2 cm ～2．1 cm ×2．9 cm적지배근막체피판수복창면，공구유리식피수복。근거환지결손형상、대소、재지배설계피판，자수지근단유리피판，원단설계위“루적”상。피판여수구소송봉합，방치인류편，공구근절지배채용전후피편식피수복。술후항염항경련등상규치료。결과술후5례피판원단출현장력성수포，경환약후유합；기여피판급공구식피균순리성활，창면균I기유합。술후30례（34지）획수방，수방시간6～25개월，중위수16．8개월。피판질지유연，외관포만。술후6개월피판량점변별각위6～9 mm，중위수7．7 mm。수공능안수지총주동활동도평분법평정체105°～230°，중위수204．6°。결론지배근막체피판수복수지피부결손창상소，수술조작간단，가이조기공능단련；술후피판후박、질지량호，피판가회복감각，시일충수복수지피부결손적호방법。
Objective To explore the clinical efficacy of dorsal fasciocutaneous flap in reparation of finger skin de -fect.Methods From October 2011 to February 2013, admitted finger skin and soft tissue defects were 33 cases (37 fingers), 19 males (22 fingers) and 14 females (15 fingers);injury to admission time 1 h-15 d;pulp skin defects in 17 fingers ,the nail bed defect in 9 fingers, middle section of palmar skin defects in 6 fingers, middle and distal section of the palmar skin de-fects in 5 fingers;flaps cut area 0.8 cm ×1.0 cm-1.9 cm ×2.7 cm.Application size is 1.0 cm ×1.2 cm-2.1 cm × 2.9 cm of the dorsal fasciocutaneous flap wounds , donor skin graft repair .According risk fingers to the defect shape , size and design of the dorsal flap , free flap from the finger proximal , distal design for the “teardrop” shape .Loose flap and suture sub-ject area, place the drainage sheet for proximal dorsal area with full thickness skin graft repair .Postoperative inflammatory an-ti-spasmodic and other conventional treatment .Results Five cases of distal flap tension blisters appear after operation , healed after changing dressing;other flaps and skin graft donor sites were successfully survived , the wounds acquired grade I healing . 30 cases (34 fingers) were followed up for 6 to 25 months, median 16.8 months.Flap soft, plump appearance.6 months af-ter operation flap point discrimination was 6-9 mm, median 7.7 mm.Hand function by finger total active activity score were assessed up to 105 °-230 °, median was 204 .6 °.Conclusion Dorsal fasciocutaneous flap repair the skin defect finger trau-ma is a simple operation , which can be performed with early exercise;flap thickness were thinner with good texture , flap re-store the feeling , which is a good approach for finger skin defect repairing .