Microsurgical replantation of retrograde avulsion injury of finger skin

Jun Wang, Hongwei Li, C. Bai, Dawei Li, Zhiru Wang
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Abstract

Objective To explore the clinical efficacy of microsurgical replantation of retrograde avulsion of finger skin. Methods From June 2013 to June 2018, 12 cases of retrograde avulsion injury of fingers were treated by the repair of fracture dislocation, skin replantation and repair of blood vessels, nerves and tendons. After operation, anti-inflammatory, anticoagulant and antispasmodic treatment were performed. They were absolutely in bed and kept warm. The blood supply, sensation and functional recovery of replanted skin were observed. Results The skin of fingers survived well in 10 cases, and a small amount of skin necrosis and scab formed in 2 cases. The wound healed well after active dressing change and scab removal. The follow-up time ranged from 6 to 12 months. 12 patients had good hand shape, soft skin, sufficient blood supply and good finger function. The total activity of flexion and extension of interphalangeal joint and metacarpophalangeal joint of the affected side were compared with those of the healthy side. According to the evaluation standard of hand function, the results were rated as excellent in 7 cases, good in 2 cases and fair 3 cases. The skin sensation recovered to S4 in 5 cases, S3 in 4 cases, S2 in 2 cases and S1 in 1 case. Conclusion The microsurgical replantation of retrograde avulsion of finger skin can reduce the necrosis rate of avulsion skin and retain the shape and function of finger to the maximum extent, which is a method worthy of reference. Key words: Finger injuries; Microsurgery; Retrograde avulsion injury; Replantation
手指皮肤逆行撕脱伤显微外科再植
目的探讨手指皮肤逆行撕脱伤显微外科再植的临床疗效。方法自2013年6月至2018年6月,对12例手指逆行性撕脱伤患者进行骨折脱位修复、皮肤再植及血管、神经、肌腱修复。术后给予抗炎、抗凝、解痉等治疗。他们完全躺在床上取暖。观察再植皮肤的血供、感觉及功能恢复情况。结果10例手指皮肤成活良好,2例出现少量皮肤坏死和结痂。经过积极换药和痂皮清除,伤口愈合良好。随访时间为6-12个月。12例患者手形良好,皮肤柔软,血液供应充足,手指功能良好。将患侧指间关节和掌指关节的屈伸总活动度与健康侧进行比较。根据手功能评价标准,结果优7例,良2例,尚可3例。5例皮肤感觉恢复到S4,4例恢复到S3,2例恢复到S2,1例恢复到S1。结论手指皮肤逆行性撕脱伤显微外科再植可降低撕脱伤皮肤的坏死率,最大限度地保留手指的形态和功能,是一种值得借鉴的方法。关键词:手指受伤;显微外科;逆行撕脱伤;再植
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