逆行穿支皮瓣修复手指末节软组织缺损的临床应用
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摘要
目的:探究逆行穿支皮瓣修复手指末节软组织缺损的临床应用效果。方法:回顾性分析2015年10月-2017年10月我院收治的60例手指末节软组织缺损患者的临床资料。将采用逆行穿支皮瓣修复术的34例患者作为观察组,采用邻指皮瓣修复的26例患者为对照组。比较两组患者手术时间和术中出血量差异;术后随访6个月,比较两组患者皮瓣存活率、皮瓣两点辨别觉距离、术后手指功能恢复情况以及皮瓣感觉功能恢复情况等指标的差异性。结果:观察组患者手术时间短于对照组(P<0.05),但两组术中出血量比较,差异无统计学意义(P>0.05);随访6个月,观察组患者皮瓣存活率、术后手指功能优良率均高于对照组(P<0.05),皮瓣两点辨别觉的平均距离、最大最小距离差值均低于对照组(P<0.05),皮瓣感觉功能分级为S5级的例数多于对照组(P<0.05)。结论:逆行穿支皮瓣修复手指末节软组织缺损的效果较好,用时较短,皮瓣存活率高,术后手指功能、皮瓣感觉功能、距离辨别功能均得到有效改善。
Objective:To investigate the clinical use of retrograde perforator flap in repairing soft tissue defects of distal segment finger.Methods:The clinical data of 60 patients with soft tissue defects of distal segment finger admitted to our hospital between October 2015 and October 2017 were retrospectively analyzed.Thirty-four patients treated with retrograde perforator flap repair were included as the study group,and 26 patients treated with cross finger flap repair were included as the control group.The differences in the operative time and intraoperative blood loss were compared between the two groups.The patients were followed up for 6 months.The differences in the flap survival rate,two-point discrimination distance of flap,recovery of postoperative finger function and flap sensory function were compared between the two groups.Results:The operative time in the study group was shorter than that in the control group(P<0.05),whereas there was no statistically significant difference in the intraoperative blood loss between the two groups(P>0.05).At 6 months after the follow-up,the flap survival rate and the excellent and good rate of postoperative finger function in the study group were higher than those in the control group(P<0.05);the mean two-point discrimination distance of flap and the difference of maximum and minimum distance in the study group were lower than those in the control group(P<0.05);and the number of flap sensory function at S5 level in the study group was more than that in the control group(P<0.05).Conclusion:Retrograde perforator flap shows good effects in repairing soft tissue defects of distal segment finger,with short operative time and high flap survival rate.It may effectively improve the postoperative finger function,flap sensory function and distance discrimination function.
Objective:To investigate the clinical use of retrograde perforator flap in repairing soft tissue defects of distal segment finger.Methods:The clinical data of 60 patients with soft tissue defects of distal segment finger admitted to our hospital between October 2015 and October 2017 were retrospectively analyzed.Thirty-four patients treated with retrograde perforator flap repair were included as the study group,and 26 patients treated with cross finger flap repair were included as the control group.The differences in the operative time and intraoperative blood loss were compared between the two groups.The patients were followed up for 6 months.The differences in the flap survival rate,two-point discrimination distance of flap,recovery of postoperative finger function and flap sensory function were compared between the two groups.Results:The operative time in the study group was shorter than that in the control group(P<0.05),whereas there was no statistically significant difference in the intraoperative blood loss between the two groups(P>0.05).At 6 months after the follow-up,the flap survival rate and the excellent and good rate of postoperative finger function in the study group were higher than those in the control group(P<0.05);the mean two-point discrimination distance of flap and the difference of maximum and minimum distance in the study group were lower than those in the control group(P<0.05);and the number of flap sensory function at S5 level in the study group was more than that in the control group(P<0.05).Conclusion:Retrograde perforator flap shows good effects in repairing soft tissue defects of distal segment finger,with short operative time and high flap survival rate.It may effectively improve the postoperative finger function,flap sensory function and distance discrimination function.
引文
[1]吴双军,赵明兴.皮瓣移植修复手指近中节软组织缺损的疗效观察[J].中国骨伤,2016,29(11):1053-1057.
[2]卢建国,杨庆达,苏瑞鉴,等.指动脉中节指背穿支血管链逆行岛状皮瓣修复指端缺损[J].实用手外科杂志,2016,30(1):43-44,47.
[3]周翔,李向荣,秦军,等.指固有动脉中节中段背侧穿支蒂逆行岛状皮瓣修复手指远端组织缺损[J].中华手外科杂志,2017,33(1):28.
[4]杨军,岳振双,汤样华,等.游离指固有动脉背侧穿支皮瓣急诊修复手指末节缺损[J].中国中西医结合外科杂志,2016,22(4):376-378.
[5]吴春,谭莉,王正理,等.游离骨间后动脉远端蒂的穿支皮瓣修复手指软组织缺损[J].中华显微外科杂志,2017,40(1):81-84.
[6]卢建国,杨庆达,苏瑞鉴,等.手指皮肤缺损显微外科修复的方法及疗效[J].临床骨科杂志,2015,18(5):598-601.
[7]邓呈亮,魏在荣,孙广峰,等.接力逆行穿支皮瓣修复手指远端及供瓣区皮肤软组织缺损[J].中华烧伤杂志,2015,31(2):107-111.
[8]王辉,杨晓溪,王斌,等.逆行穿支皮瓣接力修复第2~5指的中或末节及供区软组织缺损[J].中华显微外科杂志,2017,40(6):540-543.
[9]乔悾,汪剑威,武志刚,等.指动脉中节背侧穿支皮瓣修复手指皮肤软组织缺损[J].实用手外科杂志,2016,30(4):388-391.
[10]程邦君,郑兆宽,刘志忠,等.吻合指固有神经背侧支的远侧指间关节背侧穿支皮瓣修复手指末端组织皮肤缺损[J].中国综合临床,2017,33(5):390-392.
[11]周晓,芮永军,薛明宇,等.携带感觉神经的拇指指背侧穿支皮瓣的临床应用[J].中华手外科杂志,2017,33(1):15-17.
[12]夏雷,许玉本,张红星,等.两种手部带蒂逆行皮瓣修复手指软组织缺损的疗效分析[J].中华显微外科杂志,2017,40(2):134-138.
[2]卢建国,杨庆达,苏瑞鉴,等.指动脉中节指背穿支血管链逆行岛状皮瓣修复指端缺损[J].实用手外科杂志,2016,30(1):43-44,47.
[3]周翔,李向荣,秦军,等.指固有动脉中节中段背侧穿支蒂逆行岛状皮瓣修复手指远端组织缺损[J].中华手外科杂志,2017,33(1):28.
[4]杨军,岳振双,汤样华,等.游离指固有动脉背侧穿支皮瓣急诊修复手指末节缺损[J].中国中西医结合外科杂志,2016,22(4):376-378.
[5]吴春,谭莉,王正理,等.游离骨间后动脉远端蒂的穿支皮瓣修复手指软组织缺损[J].中华显微外科杂志,2017,40(1):81-84.
[6]卢建国,杨庆达,苏瑞鉴,等.手指皮肤缺损显微外科修复的方法及疗效[J].临床骨科杂志,2015,18(5):598-601.
[7]邓呈亮,魏在荣,孙广峰,等.接力逆行穿支皮瓣修复手指远端及供瓣区皮肤软组织缺损[J].中华烧伤杂志,2015,31(2):107-111.
[8]王辉,杨晓溪,王斌,等.逆行穿支皮瓣接力修复第2~5指的中或末节及供区软组织缺损[J].中华显微外科杂志,2017,40(6):540-543.
[9]乔悾,汪剑威,武志刚,等.指动脉中节背侧穿支皮瓣修复手指皮肤软组织缺损[J].实用手外科杂志,2016,30(4):388-391.
[10]程邦君,郑兆宽,刘志忠,等.吻合指固有神经背侧支的远侧指间关节背侧穿支皮瓣修复手指末端组织皮肤缺损[J].中国综合临床,2017,33(5):390-392.
[11]周晓,芮永军,薛明宇,等.携带感觉神经的拇指指背侧穿支皮瓣的临床应用[J].中华手外科杂志,2017,33(1):15-17.
[12]夏雷,许玉本,张红星,等.两种手部带蒂逆行皮瓣修复手指软组织缺损的疗效分析[J].中华显微外科杂志,2017,40(2):134-138.