微型组织瓣在手外科的临床应用

目的 探索微型组织瓣的概念、种类及在手外科临床应用中的技巧. 方法 应用4种微型岛状转移皮瓣和10种微型游离复合组织瓣移植,修复拇手指局部小范围皮肤软组织缺损或复合组织缺损,共计537例756指.对各种微型组织瓣的手术方法、手术要点、适应证的选择等进行了详细的阐述及比较.对其中56例经6个月～3年的随访,并对治疗结果加以分析比较. 结果 岛状转移皮瓣639指,完全成活621指,占97.2%.部分成活11指,占1.7%.失败7指,占1%.游离组织瓣移植117指全部成活,无失败病例.修复的拇手指外形美观,平整而无臃肿,感觉灵敏,两点分辨觉6～8 mm,并恢复了良好的功能,患者满意. 结论 微型组织瓣是修复拇手指局部缺损的较好方法,值得在手外科的临床中推广应用,对提高手部创伤的修复质量和治疗水平有着重要意义.

Clinical application of miniature tissue transplantation in hand surgery

Objective To explore the concept,denomination and technique of miniature tissue transplantation in hand clinic. Methods In 537 cases,local skin or composite tissue defect in 756 thumbs or fingers were repaired with 4 kinds of miniature island flap and 10 kinds of miniature vascularized composite tissue.Some of them were created in clinic practice.The precess,main points and indication of the operation were expounded and compared. Results In 639 fingers covered with miniature island flap,the transferred flaps were surviverd completely in 621 fingers(97.2%),survivered partly in 11 fingers(1.7%)and necrosised in 7 fingers(1%).In 117 fingers repaired with miniature vascularized composite tissue,all the transplanted tissues were survivered.In all the injuried fingers,beautiful outlook were recovered and no fat and clumsy were found,two-point difference was 6-8 mm,effctive sensibility and good function were restored,and all the patients were satisfied. Conclusion Miniature tissue transplantation were good methods to cover the local defect in fingers or thumbs,worth of generalization and aplication in hand clinic,and have an important significance for improve the trauma repair quality and treatment level in hand surgery.