V-Y推进皮瓣修复手指端缺损的临床应用
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摘要
目的:分析探讨V-Y推进皮瓣修复术对手指端损伤修复治疗效果的临床分析。方法:选取2016年8月-2018年3月在笔者医院手术的32例(32指)手指端缺损患者进行研究。均采取V-Y推进皮瓣修复术进行缝合,皮瓣切取范围为1.0cm×0.6cm～2.4cm×1.0cm。如有骨折则先复位固定,如有肌腱损伤则先缝合。在术前和术后12个月随访观察手指长度,皮瓣存活状况。通过观察评估V-Y推进皮瓣修复术对手指端缺损的疗效。结果:对32指进行V-Y推进皮瓣修复术后,32指均修复成功,皮瓣全部存活,且缺损手指短外形较好,术前长度为(8.36±0.50)cm,术后长度为(8.27±0.30)cm,手术前后长度比较,差异无统计学意义(P>0.05)。术后32例患者均获得了1年随访评估,随访发现手指质地较柔软,外表美观,同时无其他不良症状。结论:V-Y推进皮瓣修复术对手指端残缺患者具有较好的疗效,值得在临床推广应用。
Objective To analyze the therapeutic effect of V-Y advancement skin flap repair on hand tip injury. Methods The 32 cases(32 fingers) with finger tip defects were operated in hospital from August 2016 to March 2018. The 32 patients(32 fingers) underwent V-Y advancement skin flap repair, and t The range of skin flaps was 1.0cm×0.6cm-2.4cm×1.0cm. If there was a fracture, it would first be fixed and fixed. If there was a tendon injury, it would first be sutured. The length of fingers and the survival of skin flap were observed at 12 months before and after operation. Objective to evaluate the efficacy of V-Y in the repair of the finger tip defect. Results The 32 fingers were repaired with V-Y advancement skin flap, 32 fingers were repaired successfully. The results showed that all the repaired flaps survived, and the short shape of the finger was better. The length of the flap was(8.36±0.50)cm and the length was(8.27±0.30)cm. There was no significant difference between the length and the length of the operation(P>0.05). All the 32 patients after the operation were followed up for 1 year. The follow-up found that the fingers were soft and beautiful, with the same appearance, and the same appearance.There were no other adverse symptoms. Conclusion The V-Y advancement skin flap repair has good curative effect on the patients with poor finger tip, and is worthy of clinical application.
Objective To analyze the therapeutic effect of V-Y advancement skin flap repair on hand tip injury. Methods The 32 cases(32 fingers) with finger tip defects were operated in hospital from August 2016 to March 2018. The 32 patients(32 fingers) underwent V-Y advancement skin flap repair, and t The range of skin flaps was 1.0cm×0.6cm-2.4cm×1.0cm. If there was a fracture, it would first be fixed and fixed. If there was a tendon injury, it would first be sutured. The length of fingers and the survival of skin flap were observed at 12 months before and after operation. Objective to evaluate the efficacy of V-Y in the repair of the finger tip defect. Results The 32 fingers were repaired with V-Y advancement skin flap, 32 fingers were repaired successfully. The results showed that all the repaired flaps survived, and the short shape of the finger was better. The length of the flap was(8.36±0.50)cm and the length was(8.27±0.30)cm. There was no significant difference between the length and the length of the operation(P>0.05). All the 32 patients after the operation were followed up for 1 year. The follow-up found that the fingers were soft and beautiful, with the same appearance, and the same appearance.There were no other adverse symptoms. Conclusion The V-Y advancement skin flap repair has good curative effect on the patients with poor finger tip, and is worthy of clinical application.
引文
[1]Slack G,Lesavoy M.The diamond double-opposing V-Y flap:a reliable,simple,and versatile technique for nipple reconstruction[J].Plast Reconstr Surg,2018,125(6):1643-1648.
[2]陈轶强,卢奇昊,孙斐予,等.观察手外伤软组织缺损修复应用不同皮瓣修复术治疗效果[J].湖南师范大学学报(医学版),2015,12(5):88-91.
[3]凡玉,薛明宇,强力,等.指蹼穿支蒂V-Y推进皮瓣修复指动脉逆行岛状皮瓣供区[J].中国修复重建外科杂志,2016,30(6):787-788.
[4]曾德斌,栗鹏程,邱勋永,等.不同超薄游离穿支皮瓣修复手部软组织缺损效果比较[J].中国美容医学,2018,27(3):21-23.
[5]刘鸣江,陈亚军.带双侧血管神经束V-Y推进皮瓣修复指端缺损[J].现代医药卫生,2018,34(3):409-411.
[6]肖勇,王增涛.“V-Y”推进皮瓣设计公式的建立[J].山东医药,2017,57(32):83-84.
[7]Remache D,Chambert J,Pauchot J,et al.Numerical analysis of the V-Yshaped advancement flap[J].Med Eng Phys,2015,37(10):987-994.
[8]赵亮,张军,惠备战.两种皮瓣修复手外伤指端软组织缺损的比较分析[J].中国社区医师,2017,33(14):79-80.
[9]王辉,杨晓溪,王斌,等.带感觉的指动脉顺行岛状皮瓣修复优势侧指端缺损[J].中国骨与关节损伤杂志,2017,32(3):306-307.
[10]鲁冰.改良掌侧V-Y推进皮瓣在指端缺损治疗中的应用价值分析[J].当代医学,2017,23(1):93.
[11]Apostolou K,Niranjan NS.Lateral nasal artery perforator V-Yflap for reconstruction of nasal defects[J].J Plast Reconstr Aesthet Surg,2017,70(1):138-139.
[12]仇申强,王增涛,孙法威,等.携带单侧指动脉及神经的长V-Y推进皮瓣修复指端缺损[J].中国修复重建外科杂志,2016,30(8):1049-1050.
[13]Arpaci E,Unlu RE,Altun S,et al.Super Kutler flap:an alternative technique for reconstruction of fingertip defects[J].J Hand Surg Eur Vol,2017,42(6):626-632.
[14]于海栋.改良掌侧V-Y推进皮瓣在指端缺损治疗中的应用价值分析[J].中国疗养医学,2016,25(10):1075-1077.
[15]文文,佘远举,艾方兴,等.改良V-Y推进皮瓣联合甲床扩大治疗指端缺损[J].临床骨科杂志,2016,19(2):197-198.
[16]Wang CY,Wu CJ,Chu TS,et al.Reconstruction of a sacral pressure ulcer with an inferior gluteal artery perforator flap after failed reconstruction using bilateral V-Y advancement flaps[J].Ostomy Wound Manage,2018,64(2):45-48.
[17]Elliot D,Adani R,Hyun Woo S,et al.Repair of soft tissue defects in finger,thumb and forearm:less invasive methods with similar outcomes[J].J Hand Surg Eur Vol,2018,43(10):1019-1029.
[18]D?len U C,Ko?er U.Innovation in the planning of V-Y rotation advancement flaps:A template for flap design[J].Arch Plast Surg,2018,45(1):85-88.
[2]陈轶强,卢奇昊,孙斐予,等.观察手外伤软组织缺损修复应用不同皮瓣修复术治疗效果[J].湖南师范大学学报(医学版),2015,12(5):88-91.
[3]凡玉,薛明宇,强力,等.指蹼穿支蒂V-Y推进皮瓣修复指动脉逆行岛状皮瓣供区[J].中国修复重建外科杂志,2016,30(6):787-788.
[4]曾德斌,栗鹏程,邱勋永,等.不同超薄游离穿支皮瓣修复手部软组织缺损效果比较[J].中国美容医学,2018,27(3):21-23.
[5]刘鸣江,陈亚军.带双侧血管神经束V-Y推进皮瓣修复指端缺损[J].现代医药卫生,2018,34(3):409-411.
[6]肖勇,王增涛.“V-Y”推进皮瓣设计公式的建立[J].山东医药,2017,57(32):83-84.
[7]Remache D,Chambert J,Pauchot J,et al.Numerical analysis of the V-Yshaped advancement flap[J].Med Eng Phys,2015,37(10):987-994.
[8]赵亮,张军,惠备战.两种皮瓣修复手外伤指端软组织缺损的比较分析[J].中国社区医师,2017,33(14):79-80.
[9]王辉,杨晓溪,王斌,等.带感觉的指动脉顺行岛状皮瓣修复优势侧指端缺损[J].中国骨与关节损伤杂志,2017,32(3):306-307.
[10]鲁冰.改良掌侧V-Y推进皮瓣在指端缺损治疗中的应用价值分析[J].当代医学,2017,23(1):93.
[11]Apostolou K,Niranjan NS.Lateral nasal artery perforator V-Yflap for reconstruction of nasal defects[J].J Plast Reconstr Aesthet Surg,2017,70(1):138-139.
[12]仇申强,王增涛,孙法威,等.携带单侧指动脉及神经的长V-Y推进皮瓣修复指端缺损[J].中国修复重建外科杂志,2016,30(8):1049-1050.
[13]Arpaci E,Unlu RE,Altun S,et al.Super Kutler flap:an alternative technique for reconstruction of fingertip defects[J].J Hand Surg Eur Vol,2017,42(6):626-632.
[14]于海栋.改良掌侧V-Y推进皮瓣在指端缺损治疗中的应用价值分析[J].中国疗养医学,2016,25(10):1075-1077.
[15]文文,佘远举,艾方兴,等.改良V-Y推进皮瓣联合甲床扩大治疗指端缺损[J].临床骨科杂志,2016,19(2):197-198.
[16]Wang CY,Wu CJ,Chu TS,et al.Reconstruction of a sacral pressure ulcer with an inferior gluteal artery perforator flap after failed reconstruction using bilateral V-Y advancement flaps[J].Ostomy Wound Manage,2018,64(2):45-48.
[17]Elliot D,Adani R,Hyun Woo S,et al.Repair of soft tissue defects in finger,thumb and forearm:less invasive methods with similar outcomes[J].J Hand Surg Eur Vol,2018,43(10):1019-1029.
[18]D?len U C,Ko?er U.Innovation in the planning of V-Y rotation advancement flaps:A template for flap design[J].Arch Plast Surg,2018,45(1):85-88.