邻指皮瓣与同指背逆行岛状皮瓣修复指端缺损的临床分析

目的 观察同指背逆行岛状皮瓣修复指端缺损，探讨其临床价值。 方法 选择2013年1月—2015年10月收治的单指指端缺损患者60例入选本研究，均符合手术指征且均无明显手术禁忌证，按照数字随机法分为2组，邻指皮瓣组30例32指采取邻指皮瓣手术治疗，根据指端缺损于邻指中节背侧设计皮瓣。同指背逆行岛状皮瓣组30例36指采取同指背逆行岛状皮瓣修复手术治疗，术者根据指端缺损大小于手指中节背侧设计皮瓣，侧缘不超过手指侧中线；并于皮瓣远侧缘设计三角形皮瓣。比较2组患者住院时间等一般情况及疗效。 结果 同指背逆行岛状皮瓣组手术时间为(41.5±12.3)min，与邻指皮瓣组(42.6±13.6)min比较差异无统计学意义(P＞0.05)；同指背逆行岛状皮瓣组住院时间为(7.3±0.8)d，显著短于邻指皮瓣组(10.8±1.2)d，差异具有统计学意义(P＜0.05)。同指背逆行岛状皮瓣组皮瓣疗效优12例(40.0%)，良17例(56.7%)，可1例(3.3%)，差0例(0.0%)，优良率为96.7%(29/30)，显著优于邻指皮瓣组优11例(36.7%)，良12例(40.0%)，可7例(23.3%)，差0例(0.0%)，优良率76.7%(23/30)，χ2=5.192，P＜0.05，差异具有统计学意义。 结论 同指背逆行岛状皮瓣修复指端缺损疗效较佳，具有重要的临床价值，值得临床推广。 

Clinical analysis of adjacent finger skin flap and reverse island flap for repairing fingertip defect

Objective To investigate the clinical value of same finger reverse island flap for repairing fingertip defects. Methods Sixty cases of fingertip defect in our hospital from January,2013 to October,2015 were selected.All cases conform to operation indication and have no obvious surgical contraindication.The patients were randomly divided into two groups.Thirty-two fingers of 30 cases in the adjacent finger skin flap group were taken the adjacent finger flap surgery treatment,in the dorsal of adjacent finger middle segment designed the flap according to fingertip defects area.Thirty-six fingers of 30 cases in the same finger reverse island flap group were taken the same finger dorsal island flap repair surgery treatment,in the dorsal of finger middle segment designed flap according to the defects area,the lateral margin less than side central line.The triangle flaps at distal margin were designed.The general condition and curative effect of the two groups were compared. Results The operation time of same finger reverse island flap group was (41.5±12.3)min,adjacent finger skin flap group was (42.6±13.6)min.There was no significant difference between the two groups,P>0.05.The length of stay in the same finger reverse island flap group was (7.3±0.8)d,significantly shorter than that in the adjacent finger skin flap group(10.8±1.2)d,the difference was statistically significant,P<0.05.There were 12 cases(40.0%) superior,17 cases(56.7%) good,1 case(3.3%) fine and no inferior case in same finger reverse island flap group.There were 11 cases(36.7%) superior,12 cases(40.0%) good,7 case(23.3%) fine and no inferior case in adjacent finger skin flap group.The excellent rate of same finger reverse island flap group was 96.7%,it was significantly better than adjacent finger skin flap group’s 76.7%,χ2=5.192,P<0.05,the difference was statistically significant. Conclusion The method of reverse island flap of the same finger to repair fingertip defect has better curative effect and important clinical value,which is worth to be popularized.