| 指动脉穿支筋膜瓣联合人工真皮Ⅰ期修复手指背侧皮肤缺损 |
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投稿时间：2023-03-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 王科杰 |
WANG Ke-jie |
宁波第六医院手外科, 浙江 宁波 315040 |
Department of Hand Surgery, Ningbo 6th Hospital, Ningbo 315040, Zhejing, China |
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| 滕晓峰 |
TENG Xiao-feng |
宁波第六医院手外科, 浙江 宁波 315040 |
Department of Hand Surgery, Ningbo 6th Hospital, Ningbo 315040, Zhejing, China |
nbtxf-cn2009@163.com |
| 杨科跃 |
YANG Ke-yue |
宁波第六医院手外科, 浙江 宁波 315040 |
Department of Hand Surgery, Ningbo 6th Hospital, Ningbo 315040, Zhejing, China |
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| 阮健 |
RUAN Jian |
宁波第六医院手外科, 浙江 宁波 315040 |
Department of Hand Surgery, Ningbo 6th Hospital, Ningbo 315040, Zhejing, China |
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| 期刊信息：《中国骨伤》2023年，第36卷，第8期，第719-723页 |
| DOI：10.12200/j.issn.1003-0034.2023.08.005 |
| 基金项目:浙江省宁波市鄞州区科技项目(编号:2021AS0028) |
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中文摘要:
目的：探讨指动脉穿支筋膜瓣联合人工真皮Ⅰ期修复手指中节背侧皮肤缺损的临床疗效。
方法：自2019年1月至2020年5月对21例27指中节背侧皮肤缺损的患者采用指动脉穿支筋膜瓣联合人工真皮Ⅰ期进行修复,均为急诊病例,均伴有骨肌腱外露及骨膜、肌腱膜缺损。其中男11例,女10例;年龄18~66(39.00±8.01)岁;示指10指,中指9指,环指8指;皮肤缺损面积为(2.5~3.5) cm×(1.5~3.0) cm,骨肌腱外露面积(1.5~2.0) cm×(1.0~2.0) cm,伤后就诊时间1~6 h,受伤至手术时间3~8 h。观察术后创面愈合情况,并采用中华医学会手外科学会上肢部分功能评定试用标准进行临床疗效评价。
结果：所有患者获得随访,时间6~12(9.66±1.05)个月。手术时间45~60 min。26指术后4~6周后创面完全愈合,1指创面感染,真皮未完全上皮化,经过创面换药,8周后达到创面愈合。所有指体外观饱满、瘢痕小,愈合创面平于周围皮肤,与周围皮肤色泽质地相近,耐磨性、柔韧性良好,手指活动度正常。按照中华医学会手外科学会上肢部分功能评定试用标准评定,本组总分72~100分;优26指,良1指。
结论：指动脉穿支筋膜瓣联合人工真皮Ⅰ期修复手指中节背侧皮肤缺损简便易行,创伤小,指体外观功能恢复满意,为治疗伴有肌腱骨外露的手指皮肤缺损提供了一种有效的手术方式。 |
| 【关键词】人工真皮 筋膜瓣 中节背侧 骨肌腱外露 |
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| One-stage repair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps |
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ABSTRACT
Objective To explore clinical effects of the stageⅠrepair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps.
Methods From January 2019 to May 2020,21 patients(27 middle phalanx fingers)with full-thickness skin defect were repaired at stageⅠusing artificial dermis combing with digital artery perforator fascial flaps. All patients were emergency cases,and were accompanied by the exposure of bone tendon and the defects of periosteum and tendon membrane. Among patients,including 11 males and 10 females aged from 18 to 66 years old with an average age of (39.00±8.01) years old;9 index fingers,10 middle fingers and 8 ring fingers;range of skin defect area ranged from (2.5 to 3.5) cm×(1.5 to 3.0) cm;range of exposed bone tendon area was (1.5 to 2.0) cm×(1.0 to 2.0) cm. The time from admission to hospital ranged from 1 to 6 h,operation time started from 3 to 8 h after injury.
Results All patients were followed up from 6 to 12 months with an average of (9.66±1.05) months. The wounds in 26 cases were completely healed at 4 to 6 weeks after operation. One finger has changed into wound infection with incompletely epithelialized dermis,and achieved wound healing at 8 weeks after dressing change. All fingers were plump with less scars. The healed wound surface was similar to the color and texture of the surrounding skin. These fingers have excellent wearability and flexibility. According to the upper limb function trial evaluation standard of Hand Surgery Society of Chinese Medical Association,the total score ranged from 72 to 100. 26 fingers got excellent result and 1 good.
Conclusion StageⅠrepair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps is easy to operate with less trauma. It has made satisfactory recovery of appearance and function of fingers. It could provide an effective surgical method for clinical treatment of full-thickness skin loss of fingers with tendon and bone exposure. |
| KEY WORDS Artificial dermis Fascial flap Dorsal skin of middle phalanx fingers Tendon and bone exposure |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王科杰,滕晓峰,杨科跃,阮健.指动脉穿支筋膜瓣联合人工真皮Ⅰ期修复手指背侧皮肤缺损[J].中国骨伤,2023,36(8):719~723 |
| 英文格式: | WANG Ke-jie,TENG Xiao-feng,YANG Ke-yue,RUAN Jian.One-stage repair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(8):719~723 |
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