摘要
目的:评价指动脉皮瓣修复手指深度烧伤的临床效果。方法:手指深度烧伤伴肌腱及指骨外露患者32例共36指,应用带指动脉、神经蒂顺行岛状皮瓣推进术或指固有动脉逆行岛状皮瓣转移术(包含吻合指神经背侧支指动脉逆行岛状皮瓣转移术)治疗,分别于术后3、6、12个月运用美国手外科学会总主动活动度(TAM)系统评定标准和按英国医学研究会(BMRC)标准,对患者供瓣区及被修复手指的感觉、运动、外观以及生活和工作质量进行评价。结果:术后半个月36指皮瓣全部存活,所有伤指运动功能恢复良好,无明显关节活动受限;长度良好,色泽正常,外观不臃肿,指腹饱满,质地柔软;指固有动脉顺行岛状皮瓣及吻合指固有神经背侧支指动脉逆行岛状皮瓣感觉恢复好;日常生活不受影响且恢复了工作。29例32指获完整随访,其中行带指动脉、神经蒂顺行岛状皮瓣推进术9指的术后3、6、12个月的平均综合评定均为优;指固有动脉逆行岛状皮瓣转移术15指术后3、6、12个月的平均综合评定分别为良、良、优,吻合指神经背侧支指动脉逆行岛状皮瓣转移术8指术后3、6、12个月的平均综合评定分别为良、优、优。结论:该类术式简单,可一次完成,皮瓣外形佳,是目前较为理想的治疗方法,使手指保持良好的功能与形态,供区功能和外形也较好。
Objective： To evaluate the clinical efficacy of repairing finger deep burn with digital arterial direct island flap or digital arterial reverse island flap.Methods： Thirty-two cases（36 fingers） of finger deep burn with exposed tendon and bone were repaired by digital arterial direct island flap or digital arterial reverse island flap.Twenty-nine cases were followed up at 3,6 and 12 months after operations.According to total active motion（TAM） system of American Society for Surgery of the Hand and British Medical Research Council（BMRC） finger sensibility standard evaluation,the donor area and repaired finger feeling,movement,appearance,and the quality of life and work were evaluated.Results： All flaps were survived,29 cases were followed up for 3 to 12 months and all fingers recovered well,with sufficient length,normal color,non fat or clumsy appearance,satiation finger pulp,and soft texture.The sensation of the digital arterial direct island flap or digital arterial reverse island flap with dorsal branch of proper digital nerve was satisfactorily recovered,with no affection to the patient＇s daily life or work.Twenty-nine cases（32 fingers） got complete follow-ups,of which do take refers to artery,9 cases used the nerve＇s line island flap,the average comprehensive evaluation were all excellent at 3,6 and 12 month.In 15 cases used the inherent artery retrograde island flap,average comprehensive evaluation were good,good and optimal at 3,6 and 12 month,respectively.In 8 cases used nerve anastomosis refers to back the collateral arteries to retrograde island flap transfer,average comprehensive assessments were good,excellent,and excellent at 3,6 and 12 month,respectively.Conclusion： This once completed surgical procedure provides satisfactory flap in appearance and function,thus is practical in repair of finger deep burn.
出处
《新医学》
2012年第1期26-29,共4页
Journal of New Medicine
关键词
指动脉
岛状皮瓣
手指
修复
Digital artery
Island flaps
Finger
Repair
