带蒂腹股沟皮瓣重建手部脱手套损伤的回顾性分析

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-09-12 DOI:10.1016/j.jhsg.2025.100828

Saleh Abualhaj MD , Yazan S. Al-Zamer MD , Lina Al-Shadfan MD , Mosleh Abualhaj PhD , Ali aloun MD , Basel Joseph Massad MD

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引用次数: 0

摘要

目的评价带蒂腹股沟皮瓣复盖治疗此类损伤的临床效果，探讨影响术后并发症及皮瓣存活的相关因素。方法回顾性分析2015年至2024年23例手指或手部脱手套损伤行带蒂腹股沟皮瓣重建术的病例。分析了患者人口统计学、手术细节、并发症发生率、美学结果和功能恢复情况。结果该队列平均年龄27.9岁，男性占73.9%，吸烟率较高（73.9%）。大多数缺损涉及手指（87%），平均缺损面积为30.6 cm2，平均皮瓣面积为72.0 cm2。平均创面愈合时间32.5 d，平均住院时间3.6 d。皮瓣移植成功率为91.3%。术后并发症发生率为34.8%，其中皮瓣部分坏死（26.1%）、创面裂开（13.0%）、感染（4.3%）。39.1%的患者术中出现静脉充血，在出现并发症的患者中更为常见（P = 0.001）。其他在有和没有并发症的患者之间显示有统计学意义差异的变量包括吸烟状况（P = 0.037）、额外的手术（P = 0.037）和较小的缺陷尺寸（宽度P = 0.011，大小P = 0.032）。在超过90%的病例中，美学结果被评为良好或中性。在功能上，91.3%的患者经历了轻微至轻度残疾，平均QuickDASH评分为18.1 （SD = 14.1）。并发症患者的残疾评分较高（平均：27.9比12.9;P = 0.012）。结论腹股沟皮瓣重建仍然是处理手部脱手套损伤的一种可靠和可获得的选择，特别是在资源有限的情况下，尽管二次手术的比例相对较高，但它提供了可接受的功能和美观结果。研究类型/证据水平：治疗性

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Evaluating Pedicled Groin Flap Reconstruction in Hand Degloving Injuries: A Retrospective Analysis

Purpose

This study aimed to evaluate the clinical outcomes of pedicled groin flap coverage in such injuries and identify factors associated with postoperative complications and flap viability.

Methods

A retrospective review of 23 patients who underwent pedicled groin flap reconstruction for finger or hand degloving injuries between 2015 and 2024 was conducted. Patient demographics, surgical details, complication rates, aesthetic outcomes, and functional recovery were analyzed.

Results

The cohort had a mean age of 27.9 years, with a male predominance (73.9%) and a high smoking rate (73.9%). Most defects involved the fingers (87%), with a mean defect size of 30.6 cm² and a mean flap size of 72.0 cm². The mean wound healing time was 32.5 days, and the average hospital stay was 3.6 days. Flap success was achieved in 91.3% of the cases. Postoperative complications occurred in 34.8% of the patients, including partial flap necrosis (26.1%), wound dehiscence (13.0%), and infection (4.3%). Intraoperative venous congestion was observed in 39.1% of the cases and was more frequent among patients who developed complications (P = .001). Other variables showing statistically significant differences between patients with and without complications included smoking status (P = .037), additional procedures performed (P = .037), and smaller defect dimensions (P = .011 for width; P = .032 for size). Aesthetic outcomes were rated as good or neutral in over 90% of the cases. Functionally, 91.3% of the patients experienced minimal-to-mild disability, with a mean QuickDASH score of 18.1 (SD = 14.1). Patients with complications had higher disability scores (mean: 27.9 vs 12.9; P = .012).

Conclusions

Groin flap reconstruction remains a reliable and accessible option for managing hand degloving injuries, particularly in resource-limited settings, offering acceptable functional and aesthetic outcomes despite a relatively high rate of secondary procedures.