游离趾腓侧皮瓣修复指腹皮肤软组织缺损临床研究.docVIP

游离趾腓侧皮瓣修复指腹皮肤软组织缺损临床研究 　　【摘 要】 目的 探讨游离 趾腓侧皮瓣修复指腹皮肤软组织缺损的应用和疗效。方法 对2013年1月―2014年7月，收治20例手指末节指腹皮肤软组织缺损者，采用游离 趾腓侧皮瓣移植修复（实验组）和传统手指指腹皮肤软组织缺损利用手部带蒂皮瓣修复病例（对照组）的对照研究，分析两种不同术式对手指皮肤软组织缺损修复情况，功能、感觉恢复及外观影响，并观察疗效。结果 实验组患者手指移植皮瓣均成活，切口一期愈合，供区植皮成活良好。与对照组相比有明显优势。术后随访3-12个月，手部整体外观、功能恢复良好，皮瓣感觉部分恢复，外形饱满，与原有手指外形极其相似，患者及其家属满意。供区切取后可直接缝合或植皮修复，对供足无明显影响。结论 采用游离 趾腓侧皮瓣修复指腹皮肤软组织缺损，可恢复手指外形、功能以及精细感觉，是一种理想的游离皮瓣修复手部软组织缺损的术式。且具有供区隐蔽，皮瓣可携带神经，不需要二次手术整形，对病人简化治疗、功能恢复、外形美观等具有较好的效果。 　　【关键词】 趾腓侧皮瓣 指腹软组织缺损 显微外科 　　【Abstract】 Objective to explore the application and efficacy of abdominal skin and soft tissue defect of finger free flap from fibular side of great toe. Methods ：from January 2013 to July 2014， a total of 20 cases of finger pulp skin and soft tissue defect were treated with free toe fibular flap （experimental group） and traditional finger pulp skin and soft tissue defect by hand pedicled flap to repair cases （control group） research group， analysis of two kinds of the soft tissue defect of finger skin repair， function， sensory recovery and appearance effect， and curative effect observation. Results ：the experimental group patients with finger transplantation flaps survived， incision healing， donor skin grafts survived well. Compared with the control group， there were obvious advantages. Postoperative follow up of 3-12 months， the overall appearance of the hand， functional recovery is good， the feeling of partial restoration of the skin flap， the appearance is full， and the original shape is very similar to the fingers， patients and their families are satisfied. After the removal of direct suture or skin graft donor site had no significant effect on the donor foot. Conclusion： the free toe fibular flap to repair finger skin and soft tissue defect， can restore the appearance and function of the thumb and fine feeling， in a hand free flap for repairing soft tissue defects of the ideal. And with the donor site， the skin flap can carry the nerve， do not need two plastic surgery， to simplify the tr