摘要
目的探讨带血管的自体趾甲瓣移植修复手指指甲缺损的临床疗效。方法自2001年3月至2008年3月，根据指甲缺损的面积，对80例手指指甲缺损的患者分别采用吻合血管的自体足趾甲瓣移植的方法进行修复。结果80例患者的移植指甲全部成活。在47例供区植皮者中，除1例患者遗留部分创面经换药后愈合外，余者植皮全部成活；1例患者皮瓣于术后24h出现静脉回流不充分，予以拆除部分缝线后静脉回流改善；1例患者拇甲皮瓣稍显臃肿，予以Ⅱ期手术修整。其余患者经4—28个月的随访，功能和外形良好，修复后的指甲生长优良，参照EC Zook（1984年）指甲修复的评定标准，优良率100％。手指远端指问关节活动度接近正常，所有患者均满意。作为供区的足部其行走功能未受明显影响。结论利用自体带血管的趾甲瓣移植修复手指指甲缺损，可最大限度地改善手指的外形及功能，并可达到“缺多少，补多少”的较完美的专科修复，值得临床推广应用。
Objective To evaluate the clinical efficacy of autologous vascularized toenail flap transplantation in the reparation finger and nail defects. Methods From March 2001 to March 2008, vascularized autologous toenails were transplanted to repair the finger/nail defects of 80 patients according to individual defect areas. Results All 80 grafted nails survived. Skin of the donor area of all 47 cases survived except one with partial wound surface which was healed after change of dressings. Insufficient venous return was present in one case at 24 hours postoperatively, which was improved after removal of stitches. One case that manifested slightly bloated received phase 11 surgery. After 4 ＋ 28 months follow-up, all patients revealed favorable functions, appearance and growth of nails, the excellence rate was 100% according to EC Zook＇s （1984） evaluation standards for nail reconstruction. Distal interphalangeal joint activities were close to normal, and all patients were satisfied. No obvious impact was observed on their foot-walking functions. Conclusion The reconstruction of finger/nail defects using autologous vascularized toenail flap transplantation is an optimal method to improve utmostly the appearance and functions of defect fingers and it is worth spreading in clinical application.
出处
《中国美容整形外科杂志》
CAS
2009年第6期323-326,共4页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
指甲
自体
趾甲瓣移植
显微外科技术
Fingernail
Autologous transplantation
Toenail flap transplantation
Microsurgical technique
