自体真皮复合指趾甲床组织片修复甲床缺损78例分析万立东郭树青.DOC

自体真皮复合指（趾）甲床组织片修复甲床缺损78例分析 万立东 郭树青 【摘要】 目的 探讨利用自体真皮复合伤指剩余甲床组织片移植治疗甲床缺损。方法 对78例88指甲床缺损的患者，缺损面积达到40—90%，都有骨外露，全部利用自体真皮复合伤指的剩余甲床或切取自身足趾甲床，复合移植于甲床缺损处，打包加压包扎，术后2周拆线,观察治疗效果。结果 本组78例88指术后自体真皮复合甲床组织片移植均I期成活，2例部分坏死，经换药后愈合。新生甲板3--4个月覆盖修复甲床。术后随访时间为6—12个月，88指中甲床恢复达到优良86指(占97.7％)，差2指(占2.2％)。 结论 自体真皮复合甲床组织片移植解决了甲床缺损的修复材料与甲分离、指甲质脆等问题。方法简单，效果理想，易于推广。 【关键词】甲床缺损； 自体真皮复合指（趾）甲床组织片； 移植 Autologous DermIS composite finger (toe) repair of nail bed defect of nail bed tissue analysis of 78 cases Wan Lidong, Guo Shuqing.( Haixing County in hebei , provincehospital 061200.China) [Abstract] Objective To discuss how to use transplantation of autologous DermIS composite finger nail bed tissue slices to treat nail bed defect. Method Graftting autologous DermIS composite finger nail bed or toe nail bed of themselves on the nail bed defect of 78 cases of 88 patients with defect of nail bed defect area reaches 40-90% and exposed bone. Then they will be packed and compression bandaged.The stitches will be took out After 2 weeks and then observe therapeutic effect. Results 78 cases of postoperative autologous DermIS composite 88 fingers nail bed tissue grafts were I live, 2 partial necrosis after dressing healed. New deck covers repair of nail bed in 3-4 months. Postoperative follow-up was made in 6-12 months,.88 beds in excellent recovery to reach 86 (97.7%), 2 (2.2%). Conclusion Autologous DermIS composite graft solves the nail bed defect of nail bed tissue repairing material separated from the nail, nail polish is very brittle and so on. mThe ethod is simple, effective and easy to promote. [Key words] Nail bed defect; Autologous DermIS composite finger (toe) nail bed tissue slices; Transplantation 甲床缺损在手外伤中较为常见，传统的方法是采用废弃指甲床游离移植或自体足趾甲床游离移植，均取得了很好的疗效。但临床上往往无废弃指可以利用，而取自体过多足趾甲床移植又会对供区造成一定的损害。有报道自体真皮修复甲床缺损，有些病例出现甲分离或趾甲质脆现象。为解决以上问题。2013年3月一2014年4月，我们收治了78例88指甲床缺损的患者．一期采用自体真皮复合甲床组织片移植术。术后大部分甲床愈合良好，甲板生长及外观接近正常，无甲分离或质脆现象。效果满意。 资料与方法