全手皮肤脱套伤早期显微外科修复方法的选择

目的 研究全手皮肤脱套伤显微修复方法的最佳选择。方法 对３６例严重的全手皮磁伤，采用９种显微外科方法修复。结果 移植的１１５个组织单位全部成少昨的创面完全愈合，手部功能恢复优良率达８９％。结论采用组合组织移植一期修复全的皮肤脱套伤效果最佳。采用携带感觉神经的组织修复手掌、手指或手指掌侧能使功能更好恢复；采用甲瓣包绕指，而对２～５指采用间隔中保留，皮瓣分叶包绕手指的修得方法，效果最好；对手指指骨、肌

Selection of microsurgery in early repair of degloving injury of the hand

Objective To study the best microsurgical method for treating degloving injury of the hand Methods Thirty six cases of severe degloving injury of the hand have been repaired with 9 kinds of microsurgical methods Results The 115 units of tissue which involved in the transplantation were survival and the surfaces of wound were healed The functions of all repaired hands have recovered and the excellent and good rate was 89% Conclusions It is the best approach to repair hand degloving injuries by combined tissue transplantation The functions of hands were recovered better when repairing the palm and fingers by tissues with sensory nerves The result will be the best to repari the thumb with wrap around flap and keeps the rest at intervals of one finger and cover them with lobulated flaps If the phalanges and tendon were injuried,the best way is to reconstruct the thumb by the second toe transplantation and the rest fingers by the second or/and the third toes If the big thenal muscle was defected,part of its functions could be resumed by transplanting the short extensor muscles of hallux and toe and short abductor muscle of hallux