指背筋膜蒂皮瓣修复手指组织缺损的临床研究

目的探讨手指组织损伤应用指背筋膜蒂皮瓣修复的临床效果。方法入选我院2011年8月至2013年11月手指组织缺损94例94指,按治疗方式的不同分入两组,各47例,治疗组予以指背筋膜蒂皮瓣修复法治疗,对照组予以皮肤创面常规植皮术,术后随访半年至1年半,观察术后临床效果、并发症及术后随访情况。结果治疗组的临床总有效率显著高于对照组(85.1%vs.57.4%,P<0.05);治疗术后皮瓣全部成活,切口均为I期愈合,未发生显著肿胀及静脉危象情况,全部供区植皮成活,术后随访,伤指皮肤与皮瓣质地、色泽相近,指腹饱满。两点辨别觉9¹2 mm。患者指间关节可正常活动;治疗组的并发症、手指感觉、感染情况、手指外观等显著优于对照组(P<0.05)。结论手指组织缺损应用指背筋膜蒂皮瓣修复术,可有效降低术后发生静脉危象,临床效果确切,值得临床推广。

Clinical Study on the Repair of Finger Tissue Defect with Dorsal Fascial Pedicle Flaps

Objective To investigate the clinical effect of the repair of finger tissue defect with dorsal fascial pedicle flaps. Methods 94 cases of 94 finger tissue defect in our hospital from August 2011 to November 2013 were selected and divided into two groups according to different treatments, with 47 patients in each. The treatment group received the dorsal fascial flap repair treatment, while the control group was given routine skin grafting. After a follow-up of half a year to one and half a year, the postoperative clinical effect, complications and results of postoperative follow-up were observed. Results The total effective rate of the treatment group was significantly higher than that of the control group （85.1% vs. 57.4%, P ＆lt;0.05）. All flaps survived and the incision were healed in period I after operation, with no significant edema and venous crisis situation. All the donor skin grafts survived and during postoperative follow-up, the finger skin was similar to the flaps in the quality and color, with full finger pulp. The epicritic sensibility of two-point discrimination was 9~12 mm. The interphalangeal joints activity of patients recovered and could moved as normal. The complications, finger sensation, finger appearance and infection rate of the treatment group were significantly better than those of the control group （P ＆lt;0.05）. Conclusions Application of dorsal fascial flap in the repair of finger tissue defect can reduce the incidence of postoperative vein crisis and have exact clinical effect, so it is worthy of clinical promotion.