Clinical observation of combined skin flap and abdominal flap for repair of distal finger degloving injury
10.3760/cma.j.issn.1001-2036.2018.02.004
- VernacularTitle:一种新型瓦合皮瓣与腹部皮瓣修复手指远节脱套伤的疗效观察
- Author:
Jianfeng ZHANG
1
,
2
;
Yongxin HUO
;
Ruizheng HAO
;
Huanyou YANG
;
Wei WANG
;
Bin WANG
;
Wenlong ZHANG
;
Yongcheng HU
Author Information
1. 300211天津,天津医科大学
2. 唐山市第二医院手外科
- Keywords:
Degloved injury;
Finger;
Dorsal branch,proper palmar digital artery;
Island flap;
Cross finger skin flap;
Combined skin flap;
Repair
- From:
Chinese Journal of Microsurgery
2018;41(2):116-121
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical effect and operation difficulty of the combined skin flap with reversed proper palmar digital arterial dorsal branch island flap and cross-finger flap and the abdominal flap in the treatment of distal finger degloving injury.Methods Inclusion criteria:①Soft tissue defect far beyond the level of distal interphalangeal joints.②The inured finger was from second to fifth.③Single finger injury.④ Iniury time within 8 h.Exclusive criteria:①With tendon injury.② Multiple finger injuries.③Followed-up time within 6 months.Between February,2009 and September,2016,52 patients (52 fingers) with distal finger degloving injury were reviewed,there were 32 males and 20 females,aged from 18 to 60 (36.02±11.00) years.The time from injury to operation was 2.5-8.0 (4.81±1.28) h.Affected fingers included index finger in 15 cases,middle finger in 22 cases,ring finger in 10 cases,and little finger in 5 cases.Twenty patients (20 fingers) were treated by combined skin flap with reversed digital arterial dorsal branch island flap and cross-finger flap(group combined-flap).The cubital skin was grafted onto the donor sites.Thirty-two patients (32 fingers) were treated by abdominal flap (group abdominal-flap).Results The patients were followed-up 6-25 (9.25±3.97) months.The operation time:group combined-flap was 80-130 (98.46±8.34) min and group abdominal-flap was 85-125(107.84±8.63)min.There was no significant difference in two groups (P＞0.05).Pedicle division time:group combined-flap was 15-24 (16.75±1.74) d and group abdominal-flap was 24-45 (28.31±5.12) d.There was a significant difference in two groups (P＜0.05).And the pedicle division time in group combined-flap was much shorter than in group abdominal-flap.Flap function at last follow-up,the excellent and good rate of the flap in group combined-flap and group abdominal-flap was 90.00％ and 59.38％,respectively.There was a significant difference in two groups (P＜0.05),and the flap function in group combined-flap was much better than in group abdominal-flap.Affected finger function at last follow-up,the excellent and good rate of the affected fingers was 95.00％ and 71.88％.There was a significant difference in two groups (P＜0.05),and the affected finger function in group combined-flap was much better than in group abdominal-flap.Conclusion The combined skin flap with reversed digital arterial dorsal branch island flap and cross-finger flap is a simple and high-survival-rate flap,whose texture,appearance and clinical outcome for repair of distal finger degloving injury are much better than traditional abdominal flap.
