带血管吻合的足趾甲床皮瓣移植修复手指甲床及软组织缺损

中华显微外科杂志 Pub Date : 2019-02-25 DOI:10.3760/CMA.J.ISSN.1001-2036.2019.01.003

Muwei Li, Lifeng Ma, Honggang Wang, Shaogeng Huang, Gong Wu, Zhe Zhang, Yanjun Yang, Ziqing Zhang

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The area of slice nail bed flap incised during operation were from 2.5 cm×1.2 cm to 3.2 cm×1.8 cm, and the donor site was sutured directly. All patients were followed-up regularly for nail appearance, function and donor healing. Among them, 11 cases were followed-up by clinic, 4 cases by WeChat, and telephone follow-up was performed in 1 case. \n \n \nResults \nThe nail-bed flap after transplantation survived successfully. The followed-up time were from 6 to 18 months, the average time was 9 months. Longitudinal spine and rough appearance occurred in 1 case. Others were flat, smooth, complete attachment of nail body and nail bed. The flaps had good appearance, texture and elasticity at 6 months after surgery, and two-point discrimination was 6-12 mm(average, 8 mm). The toenails at donor sites grew well. No walk-associated pain after long-term following-up. 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引用次数: 0

摘要

目的探讨带血管吻合的大脚趾甲床皮瓣移植修复手指部分甲床及软组织缺损的临床效果。方法自2015年1月至2018年3月，对16例（16指）手指部分甲床缺损采用带血管吻合的大脚趾甲床皮瓣移植修复。所有病例均合并手指远端掌侧软组织缺损。甲床缺损面积为0.8cm×0.5cm～1.2cm×1.0cm，软组织缺损面积为1.2cm×1.0 cm～2.5cm×1.5cm，伤后平均手术时间为3.6小时（1小时～8小时）。术中切开的甲床片皮瓣面积为2.5cm×1.2cm～3.2cm×1.8cm，供区直接缝合。所有患者都定期随访指甲外观、功能和供体愈合情况。其中门诊随访11例，微信随访4例，电话随访1例。结果甲床皮瓣移植成功。随访时间6～18个月，平均9个月。1例出现纵脊和粗糙外观。其他指甲平整、光滑、甲体与甲床附着完整。术后6个月，皮瓣外观、质地和弹性良好，两点鉴别为6-12mm（平均8mm）。移植部位的脚趾甲生长良好。长期随访后无行走相关疼痛。术后6个月，根据指甲再生疗效评价标准，优12例，良3例，合格1例。结论带血管吻合的足趾甲床皮瓣移植修复部分甲床及手指软组织缺损是修复手指甲床缺损的有效方法之一。关键词：甲床缺损；大脚趾甲床；血管吻合；修理

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Transplantation of slice nail bed flap of great toe with vascular anastomosisin repairing nail bed and soft tissue defect of fingers

Objective To discuss the clinical effect of transplantation of slice nail bed flap of great toe with vascular anastomosis in repair of partial nail-bed and soft tissue defect at fingers. Methods From January, 2015 to March, 2018, 16 cases (16 fingers) of partial nail-bed defect at fingers were repaired with transplantation of slice nail bed flap of great toe with vascular anastomosis. All cases were combined with palmar soft tissue defect at distal segment fingers. The area of nail bed defects were from 0.8 cm×0.5 cm to 1.2 cm×1.0 cm. The area of soft tissue defects were from 1.2 cm×1.0 cm to 2.5 cm×1.5 cm. The average time from injury to operation was 3.6 hours after injuries(ranging from 1 hour to 8 hours). The area of slice nail bed flap incised during operation were from 2.5 cm×1.2 cm to 3.2 cm×1.8 cm, and the donor site was sutured directly. All patients were followed-up regularly for nail appearance, function and donor healing. Among them, 11 cases were followed-up by clinic, 4 cases by WeChat, and telephone follow-up was performed in 1 case. Results The nail-bed flap after transplantation survived successfully. The followed-up time were from 6 to 18 months, the average time was 9 months. Longitudinal spine and rough appearance occurred in 1 case. Others were flat, smooth, complete attachment of nail body and nail bed. The flaps had good appearance, texture and elasticity at 6 months after surgery, and two-point discrimination was 6-12 mm(average, 8 mm). The toenails at donor sites grew well. No walk-associated pain after long-term following-up. Six months after surgery, according to standard for efficacy evaluation of nail regeneration, 12 cases were excellent, 3 cases were good and 1 case was acceptable. Conclusion Transplantation of slice nail bed flap of great toe with vascular anastomosis in repair of partial nail-bed and soft tissue defect at fingers is one of the effective methods for repairing nail-bed defect at fingers. Key words: Nail bed defect; Nail bed fiap of great toe; Vascular anastomosis; Repair

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来源期刊

中华显微外科杂志

CiteScore

0.50

自引率

0.00%

发文量

6448

期刊介绍： Chinese Journal of Microsurgery was established in 1978, the predecessor of which is Microsurgery. Chinese Journal of Microsurgery is now indexed by WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 1.731 in 2017, ranking the third among all journal of comprehensive surgery. The journal covers clinical and basic studies in field of microsurgery. Articles with clinical interest and implications will be given preference.