踇甲瓣切除后供足创面修复的远期随访

Long-term follow-up of the coverage of the donor defect of wrap-around flap transfer

关键词:  踇趾皮甲瓣  覆盖  外科皮瓣

Key words:  wrap-around flap  coverage  surgical flaps  

摘要:

Abstract:

Objective To explore the treatment and causation of necrosis of skin flap and free skin graft resurfacing donor defect after incising wrap-around flap. Methods A retrospective study was conducted to analyze 120 cases with thumb reconstruction by transplanting wrap-around flap. Based on the operative techniques all cases were classified into two groups; A group, 76 cases, transplanted intermediate or thick split-thickness skin graft to repair the defect after incising wrap-around flap, and B group, 44 cases, applied the second toe free flap and limited dermoplasty. Results All cases had a mean follow-up of 3.2 years (from 1 to 7 years). Among the 120 cases, necrosis occured in the tibial side of the gloss-shape flap partly or on the top in 2 cases; partly in the dermoplasty area of the raw surface in 10 cases. Of all cases, 10 were healed through dressing changes in 2 months; 3 healed through dressing changes in more than 2 months; 1 healed after reoperation in more than 2 months. All the patients were satisfied with the appearance and function except for a few patients who disaffected with the long term treatment. Conclusion Free skin graft transplantation is a ideal method to resurfacing donor defect after incising the wrap-around flap. Unsuitable operation is the main causation of necrosis of skin flap and free skin graft, so the regular covering methods should be emphasized.