半趾甲瓣移植手术供区创面的修复处理

目的 探讨半趾甲瓣移植术的供区创面修复方法.方法 自2004年2月至2010年9月,采用带蒂或游离皮瓣修复趾甲瓣足趾供区创面36例40指.趾供区面积较小者13趾采用第一跖背皮瓣、7趾用第二趾动脉皮瓣修复;面积大者采用游离皮瓣修复,其中足底内侧皮瓣3趾,腓动脉穿支皮瓣5趾,跗外侧动脉皮瓣2趾,腓肠动脉内侧支皮瓣3趾.第二趾半趾甲瓣再造手指7趾,其创面均采用(母)趾腓侧岛状皮瓣覆盖.结果 20例术后获得6个月至5年随访,其中2例甲缘外露在皮瓣外,18例(母)趾、第二足趾外观近似正常,皮瓣平整无破溃,皮瓣颜色质地好;游离皮瓣中有7例恢复保护性感觉;修复足趾屈伸活动正常,行走无不适感.结论 用皮瓣移植覆盖(母)趾及第二趾半趾甲瓣创面是理想修复方法,游离皮瓣移植好于带蒂移植.

Abstract：

Objective To explore the wound healing of semi-toe nail flap donor site after transplantation. Methods To repair small wounds,on 13 toes the first metatarsal dorsal flaps were applied,and on 7 toes the second toe digital flaps were applied.While,to repair large wounds,free flaps were applied,including foot inside flaps on 3 toes,peroneal artery perforator flaps on 5 toes,tarsal lateral artery flaps on 2 toes,and phil bowel artery inside branch flaps on 3 toes.Wounds remaining on semi-toe nail flaps of 7 toes were all covered with fibular island flaps of the first toes. Results Twenty cases were followed up,and the rang between 6 months to 5 years.The nail margin was exposed out of the lateral flaps in 2 cases.The first toes and the second toes appeared nearly normal in the other 18 cases.The flaps appeared smooth,flexible appearance with nice color and no ulceration.Seven cases applied with free flaps recovered protective sensibility with no complaint. Conclusion To cover wounds on semi-toe nail flaps of the first toes and the second toes with flaps is an ideal treatment method.The method of free flap transplantation is superior to vascular pedicle flap graft.

Treatment of the donor site after wound healing of semi-toe nail flap

Objective To explore the wound healing of semi-toe nail flap donor site after transplantation. Methods To repair small wounds,on 13 toes the first metatarsal dorsal flaps were applied,and on 7 toes the second toe digital flaps were applied.While,to repair large wounds,free flaps were applied,including foot inside flaps on 3 toes,peroneal artery perforator flaps on 5 toes,tarsal lateral artery flaps on 2 toes,and phil bowel artery inside branch flaps on 3 toes.Wounds remaining on semi-toe nail flaps of 7 toes were all covered with fibular island flaps of the first toes. Results Twenty cases were followed up,and the rang between 6 months to 5 years.The nail margin was exposed out of the lateral flaps in 2 cases.The first toes and the second toes appeared nearly normal in the other 18 cases.The flaps appeared smooth,flexible appearance with nice color and no ulceration.Seven cases applied with free flaps recovered protective sensibility with no complaint. Conclusion To cover wounds on semi-toe nail flaps of the first toes and the second toes with flaps is an ideal treatment method.The method of free flap transplantation is superior to vascular pedicle flap graft.