急诊手再造几种术式的比较研究

目的探讨修复手部复合组织缺损急诊手再造的最佳术式。方法采用携带伴有足拇趾近节腓侧皮瓣的双侧趾蹼皮瓣、双侧足背皮瓣的双足3趾移植再造手49例,带两套血供的拇趾甲皮瓣+第二、三足趾及前臂皮瓣组合移植再造手29例,带足背皮瓣的第二足趾或拇趾甲皮瓣+远隔游离皮瓣移植再造手22例,废弃指异位再造手16例。结果再造手116例全部成活,成活率100%,感觉及运动功能恢复满意。结论吻合血管的多元组织组合移植急诊再造手,具有最大限度的保留手部残存非失活组织及功能,具有最大限度修复重建手部功能的特点,是较理想的治疗方法。

Comparative research on several procedures for emergency hand reconstruction

Objective To investigate the best method of emergency thumb and finger reconstruction in composite hand tissue defect.Methods Forty-nine cases were reconstructed by transfer of 3 toe flap with double-sides toe-web and double-sides back of toe. The 29 patients were reconstructed by transfer of first toe and nail flap with double blood supply and composite flap with second and third toes22 hands were reconstructed by transfer of second toe or first toe and nail flap with foot-back flap plus distal free flap.Transplantation of abandoned fingers was used to reconstruct hand in 16 cases.Results The survival rate of reconstructed hand was 100%. The sensitive and active functions were satisfactory.Conclusion Emergency hand reconstruction with composite tissue transplantation by microvascular anastomosis allows maximum salvage of residual tissue and function of hand.It features in ulmost repair and functional reconstruction.It is highly recommended as a relatively perfect treatment.