CAJ | 학술논문

背景：断指再植损伤性质不同，组织损伤各异，单纯的组织或者血管、神经损伤用传统的邻指、腹部皮瓣等可以覆盖创面，容易修复，但时间长，需2次手术，外形患者不满意。目的：探讨Flow-through踇趾腓侧皮瓣游离移植在断指再植中的修复效果。方法：2011年1月至2013年10月应用Flow-through踇趾腓侧皮瓣游离移植修复合并软组织缺损的断指11例，其中男8例，女3例；年龄23-42岁；皮肤缺损范围2.0 cm×1.5 cm至4.0 cm×2.2 cm；血管缺损1-3 cm，平均1.5 cm；皮瓣切取范围在2.2 cm×1.7 cm至4.5 cm×2.5 cm。结果与结论：随访6-18个月，全部断指均成活。10例皮瓣一期愈合；1例皮瓣边缘部分坏死，经过换药后逐渐愈合，皮瓣外形好，色泽质地与正常手指基本相似。患指末梢两点分辨觉为4-10 mm。手指屈伸功能良好，根据中华医学会手外科分会上肢部分功能评定标准，优9例，良2例。提示Flow-through踇趾腓侧皮瓣游离移植能同时修复皮肤软组织缺损和血管缺损，对于合并有节段性皮肤软组织缺损的断指，是一种较好的修复方案。
배경：단지재식손상성질불동，조직손상각이，단순적조직혹자혈관、신경손상용전통적린지、복부피판등가이복개창면，용역수복，단시간장，수2차수술，외형환자불만의。목적：탐토Flow-through무지비측피판유리이식재단지재식중적수복효과。방법：2011년1월지2013년10월응용Flow-through무지비측피판유리이식수복합병연조직결손적단지11례，기중남8례，녀3례；년령23-42세；피부결손범위2.0 cm×1.5 cm지4.0 cm×2.2 cm；혈관결손1-3 cm，평균1.5 cm；피판절취범위재2.2 cm×1.7 cm지4.5 cm×2.5 cm。결과여결론：수방6-18개월，전부단지균성활。10례피판일기유합；1례피판변연부분배사，경과환약후축점유합，피판외형호，색택질지여정상수지기본상사。환지말소량점분변각위4-10 mm。수지굴신공능량호，근거중화의학회수외과분회상지부분공능평정표준，우9례，량2례。제시Flow-through무지비측피판유리이식능동시수복피부연조직결손화혈관결손，대우합병유절단성피부연조직결손적단지，시일충교호적수복방안。
BACKGROUND:The severity of tissue injury varies with the causes of the amputated finger. Simple soft tissue, vessels or nerves injury could be easily repaired by adjacent finger flap or abdominal flaps. However, these treatments are short of long repair time, reoperation and unsatisfactory appearance of the finger. OBJECTIVE:To investigate the efficiency of Flow-through flap from the fibular side of great toe to repair skin and soft tissue defects in digital replantation. METHODS:From January 2011 to October 2013, Flow-through flap from the fibular side of great toe was applied to repair soft tissue injury in digital replantation for 11 cases (8 males and 3 females, age ranged from 23 to 42 years. Skin defects ranged from 2.0 cm ×1.5 cm to 4.0 cm×2.2 cm; vascular defect ranged from 1-3 cm, 1.5 cm averagely; and the flap size ranged from 2.2 cm×1.7 cm to 4.5 cm×2.5 cm. RESULTS AND CONCLUSION:The folow-up time of al patients was 6-18 months. Digital replantation was successful in al the 11 cases. Ten cases were healed by first intention, and one case was gradualy rescued after dressing change. Patients were satisfied with the flap and the peripheral sensation. The peripheral discrimination of patients was 4 to 10 mm. The fingers functioned wel in flexion and extension. Of the 11 cases, 9 cases were valued excelent and 2 cases was rated as good, according to the upper extremity function evaluation standard of the Hand Surgey Branch of Chinese Medical Association. Flow-through flap from the fibular side of great toe is an ideal method to repair skin soft tissue and vascular defects in digital replantation.