CAJ | 학술논문

目的探讨第1跖背(底)动脉蒂双叶皮瓣修复相邻两手指中末节缺损的临床应用效果. 方法自2010年11月至2013年6月,应用第1跖背(底)动脉蒂(母)趾腓侧皮瓣和第2趾胫侧皮瓣联合移植修复相邻两手指中末节缺损9例,为解决动脉跨度不足及皮瓣供区骨和(或)肌腱外露、植皮不易成活的缺陷,将血管分叉处裸露的血管蒂部及足部供区用人工真皮覆盖,3周后切断皮桥,足部供区拆除人工真皮薄膜再切取自体中厚皮片植皮修复. 结果术后9例18块皮瓣及供区植皮全部成活.随访4～12个月,修复效果满意,皮瓣色泽、质地与受区近似,皮瓣两点辨别觉8 ～12 mm,手指关节功能恢复良好,供区植皮外观饱满,无破溃、疼痛及瘢痕增生形成. 结论第1跖背(底)动脉蒂双叶皮瓣联合人工真皮修复相邻两手指中末节缺损伤,解决了蒂部跨度不足、不能同时修复中末节缺损的缺陷,降低了手术难度及风险,同时足部供区处理简单、提高了足部供区植皮的成活率,治疗效果满意.
목적 탐토제1척배(저)동맥체쌍협피판수복상린량수지중말절결손적림상응용효과. 방법 자2010년11월지2013년6월,응용제1척배(저)동맥체(모)지비측피판화제2지경측피판연합이식수복상린량수지중말절결손9례,위해결동맥과도불족급피판공구골화(혹)기건외로、식피불역성활적결함,장혈관분차처라로적혈관체부급족부공구용인공진피복개,3주후절단피교,족부공구탁제인공진피박막재절취자체중후피편식피수복. 결과 술후9례18괴피판급공구식피전부성활.수방4～12개월,수복효과만의,피판색택、질지여수구근사,피판량점변별각8 ～12 mm,수지관절공능회복량호,공구식피외관포만,무파궤、동통급반흔증생형성. 결론 제1척배(저)동맥체쌍협피판연합인공진피수복상린량수지중말절결손상,해결료체부과도불족、불능동시수복중말절결손적결함,강저료수술난도급풍험,동시족부공구처리간단、제고료족부공구식피적성활솔,치료효과만의.
Objective To explore the clinical effect that the free twin-flap with the first dorsal (bottom) metatarsa artery repair the defects of distal in adjacent two fingers.Methods The twin-flap from the big toe and the second toe based on a single vascular pedicle of the firstl dorsal (bottom) metatarsa artery was designed in this article.From November 2010 to June 2013,this twin-flap was transferred in 9 patients.In order to solve the problems:the shortage of arterial span,the bone and (or)tendon exposed in the donor site,the thickness skin graft resurfaced in the donor site was not easy to survive,the bare vascular pedicle and the donor site were covered with artificial dermis for 3 weeks.After 3 weeks,cutting skin bridge and removing the thin of artificial dermis,the donor site was resurfaced by thickness skin graft.Results All cases were followed up for 4 to 12 months.All transfering flaps and the thickness skin graft were survival.The colours and texture of the flaps matched the recipient site.2-point discrimination ranged from 8 to 12 mm.Finger flexion and extension was satisfactory.The appearance of the donor site was well-stacked.No case had successive ulces,pain and car.Conclusion The twin-flap from the big toe and the second toe based on a single vascular pedicle of the first dorsal (bottom) metatarsal artery combined with artificial dermis to repair the defects of distal in adjacent two fingers.For one side,this operation can solve he shortage of arterial span and repair the defects of distal in adjacent two fingers at the same time.For another,it can provid a easy method for deal with the donor site and raise the survial rate of the thickness skin graft.Besides,it also is easy and safe,clinical effect is satisfaction.