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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (12) : 972 -975. doi: 10.3877/cma.j.issn.1674-0785.2020.12.004

所属专题: 文献

临床研究

“三合一”预制皮瓣移植修复拇指脱套伤的临床应用
张功林1, 胡玉祥2, 伍辉国2, 师富贵1, 何如祥1, 胡军1,(), 孙萍1, 岳孝太1, 赵文学1, 王伟世1   
  1. 1. 730050 甘肃兰州,甘肃省兰州市兰州手足外科医院手外科
    2. 317500 浙江温岭,浙江省台州骨伤科医院骨科
  • 收稿日期:2020-05-04 出版日期:2020-12-15
  • 通信作者: 胡军
  • 基金资助:
    兰州市科技局项目(2018-4-60)

Repair of degloved injury of the thumb by "three-in-one" prefabricated flap transplantation

Gonglin Zhang1, Yuxiang Hu2, Huiguo Wu2, Fugui Shi1, Ruxiang He1, Jun Hu1,(), Ping Sun1, Xiaogtai Yue1, Wenxue Zhao1, Weishi Wang1   

  1. 1. Department of Hand Surgery, Lanzhou Hand and Foot Surgery Hospital, Lanzhou 730050, China
    2. Department of Orthopaedics, Orthopaedics and Traumatology Hospital of Taizhou, Wenling 317500, China
  • Received:2020-05-04 Published:2020-12-15
  • Corresponding author: Jun Hu
引用本文:

张功林, 胡玉祥, 伍辉国, 师富贵, 何如祥, 胡军, 孙萍, 岳孝太, 赵文学, 王伟世. “三合一”预制皮瓣移植修复拇指脱套伤的临床应用[J]. 中华临床医师杂志(电子版), 2020, 14(12): 972-975.

Gonglin Zhang, Yuxiang Hu, Huiguo Wu, Fugui Shi, Ruxiang He, Jun Hu, Ping Sun, Xiaogtai Yue, Wenxue Zhao, Weishi Wang. Repair of degloved injury of the thumb by "three-in-one" prefabricated flap transplantation[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(12): 972-975.

目的

总结“三合一”预制皮瓣移植修复拇指脱套伤的临床应用效果。

方法

2007年1月至2018年1月兰州手足外科医院应用“三合一”预制皮瓣移植修复拇指脱套伤8例。其中,男7例,女1例;年龄22~39岁,平均(32.0±9.6)岁。预制皮瓣的旋股外侧降支血管动脉和静脉分别与桡动脉背侧支动脉和静脉相吻合,供区创面行直接缝合。

结果

1例供区发生小的切口裂开,经再次缝合后愈合,预制皮瓣全部成活,取得了较满意的效果。术后随访2~5.5年,平均(3.5±1.6)年,供区无明显的功能障碍,受区外形较好。

结论

“三合一”预制皮瓣移植技术修复拇指脱套伤效果优良,尤其适合不宜行甲瓣移植手术的拇指脱套伤。

Objective

To observe the clinical effects of the repair of degloved injury of the thumb by "three-in-one" prefabricated flap transplantation.

Methods

Between January 2007 and January 2018, eight patients with degloved injury of the thumb underwent repair by "three-in-one" prefabricated flap transplantation. There were seven males and one female, aged from 22 to 39 years (mean of 32.0±9.6 years). The artery and vein of the descending branch of the lateral circumflex femoral artery of the prefabricated flap were anastomosed to the artery and vein of the dorsal branch of the radial artery, respectively. The wound of the donor site was repaired by direct suture.

Results

One donor developed small incision dehiscence, but the wound was healed after resuturing. Prefabricated flaps survived completely with satisfactory clinical results. Follow-up period ranged from 2.0 to 5.5 years, mean of (3.5±1.6) years. There was no remarkable function morbidity of the donor site. All cases had good appearance in recipient site.

Conclusion

This technique has excellent effect for degloved injury of the thumb for which toenail flap transplantation is not suitable.

图1 “三合一”预制皮瓣移植修复拇指脱套伤情况及预后 图a为修复前左拇指外形,图b为切取右足跖内侧全厚皮,图c为右股前外侧切口设计,图d为植皮后外形,图e为切取预制皮瓣,图f为左拇指术后2周外形,图g为左拇指术后1年外形,图h为左拇指术后1年掌侧观,图i为左拇指术后1年背侧观
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