CAJ | 학술논문

目的：探讨腕前区微型静脉皮瓣在合并皮肤软组织和血管缺损性断指再植中的应用效果。方法以2012年4月~2013年3月在本院接受缺损性断指再植术的67例患者为研究对象，根据手术方式分为两组，分别进行腕前区微型静脉皮瓣桥接(A组，32例)和血管移植后带蒂皮瓣修复(B组，35例)，比较两组的术后皮瓣参数(术后皮瓣成活率、皮瓣外形、皮瓣颜色、皮肤感觉)和供区影响参数(外形、皮肤感觉、功能)。结果 A组2例皮瓣完全坏死，1例皮瓣边缘部分坏死，经换药后延迟愈合；B组完全坏死3例，皮瓣边缘部分坏死2例，经换药后愈合。两组的术后皮瓣成活率、皮瓣颜色、皮肤感觉差异无统计学意义(P>0.05)，皮瓣外形比较，差异有统计学意义(P<0.05)。两组的供区皮肤感觉、功能差异无统计学意义(P>0.05)，外形比较差异有统计学意义(P<0.05)。结论腕前区微型静脉皮瓣适用于缺损面积不大的合并皮肤软组织和血管缺损性断指再植。
목적：탐토완전구미형정맥피판재합병피부연조직화혈관결손성단지재식중적응용효과。방법이2012년4월~2013년3월재본원접수결손성단지재식술적67례환자위연구대상，근거수술방식분위량조，분별진행완전구미형정맥피판교접(A조，32례)화혈관이식후대체피판수복(B조，35례)，비교량조적술후피판삼수(술후피판성활솔、피판외형、피판안색、피부감각)화공구영향삼수(외형、피부감각、공능)。결과 A조2례피판완전배사，1례피판변연부분배사，경환약후연지유합；B조완전배사3례，피판변연부분배사2례，경환약후유합。량조적술후피판성활솔、피판안색、피부감각차이무통계학의의(P>0.05)，피판외형비교，차이유통계학의의(P<0.05)。량조적공구피부감각、공능차이무통계학의의(P>0.05)，외형비교차이유통계학의의(P<0.05)。결론완전구미형정맥피판괄용우결손면적불대적합병피부연조직화혈관결손성단지재식。
Objective To discuss application effect of miniature vein skin flap of anterior carpal region in reunion of severed finger complicated with skin and soft tissue and vascular defect. Methods 67 cases given defective severed fin-ger reunion operation in our hospital from April 2012 to March 2013 were selected as the research objects,according to the operation way they were divided into two groups,and the two groups was given miniature vein skin flap of anterior carpal region (group A,n=32) and pedicled skin flap repairing after vascular transplantation (group B,n=35) respectively. Postoperative parameter of skin flap (survival rate,shape,color and skin feeling of skin flap after operation) and parame-ter affectiong donor site (shape,skin feeling and function) between two groups were compared. Results 2 patients had complete necrosis of skin flap,and 1 case with partial necrosis of flap margin,and late healed after dressing change in group A,3 cases had complete necrosis,2 cases with partial necrosis of flap margin and healed after dressing change. There was no statistical difference of survival rate,color and skin feeling of skin flap after operation between two groups (P>0.05),and there was a statistical difference of shape of skin flap between two groups (P<0.05).There was no statisti-cal difference of skin feeling and function for donor site between two groups (P>0.05),and there was a statistical differ-ence of shape between two groups (P<0.05). Conclusion Miniature vein skin flap of anterior carpal region is suitable for reunion of severed finger complicated with skin and soft tissue and vascular defect with small defective area.