CAJ | 학술논문

目的：探讨手指末节指甲半月线以远完全离断原位缝合固定+皮下包埋再植方法及疗效。方法选择我院2008年1月~2013年1月36例40指末节指甲半月线以远离断指，经彻底清创、拔除指甲、去除角质层、内固定、皮肤软组织原位缝合，并将末节指腹和指缘皮肤切开2~3刀至皮下，埋入对侧胸壁或腹壁皮下，16~35 d取出离断指。结果36例40指，成活38指，部分坏死1例，后行邻指皮瓣；完全坏死1例。术后随访3个月~2年，手指末节血运、弹性、外观及活动良好，痛温觉恢复，手指功能恢复满意。结论采用去角质层原位缝合皮下包埋法治疗指甲半月线以远完全离断方法简单实用，疗效优良，特别适合无法吻合血管的末节离断及无纤维吻合技术的基层医院。
목적：탐토수지말절지갑반월선이원완전리단원위봉합고정+피하포매재식방법급료효。방법선택아원2008년1월~2013년1월36례40지말절지갑반월선이원리단지，경철저청창、발제지갑、거제각질층、내고정、피부연조직원위봉합，병장말절지복화지연피부절개2~3도지피하，매입대측흉벽혹복벽피하，16~35 d취출리단지。결과36례40지，성활38지，부분배사1례，후행린지피판；완전배사1례。술후수방3개월~2년，수지말절혈운、탄성、외관급활동량호，통온각회복，수지공능회복만의。결론채용거각질층원위봉합피하포매법치료지갑반월선이원완전리단방법간단실용，료효우량，특별괄합무법문합혈관적말절리단급무섬유문합기술적기층의원。
Objective To explore the treatment outcome of in situ suture fixation combined with embedding method in the treatment of complete amputation of fingertip distal to nail semilunar line. Methods From Jan 2008 to Jan 2013, 36 cases (40 fingers) with complete amputation of fingertip distal to nail semilunar line in our hospital. After thorough de-bridement, removal of the nail and stratum corneum, internal fixation, skin and soft tissue in situ suture, cut 2 to 3 knivies to the subcutaneous in the abdomen and edge of the distal finger, then the wounded finger was buried in the subcutaneous of the lateral thoracic or abdominal wall, take out the wounded finger after 16 to 35 days. Results 36 cases (40 fingers), 38 fingers survived, 1 case happened partial necrosis (used adjacent finger flap), 1 case happened complete necrosis. The postoperative follow-up for 3 months to 2 years, the blood transport, elasticity, appearance and activity of the fingertips were good, pain and temperature sensation recovery, finger function recovery well. Conclusion For the repair of the complete amputation of fingertip distal to nail semilunar line, in situ suture fixation combined with em-bedding method is simple and practical, the treatment outcome is also good, it is especially suitable for fingertip ampu-tation, which blood vessel can not be repaired, and primary hospital without fiber anastomosis technique.