Koch H, Kielnhofer A, Hubmer M, Scharnagl E
Division of Plastic Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria.
Br J Plast Surg. 2005 Dec;58(8):1131-5. doi: 10.1016/j.bjps.2005.04.047. Epub 2005 Jul 21.
As relevant literature is scarce, this study was undertaken to assess the donor site morbidity of cross-finger flaps. It included 23 patients who had undergone reconstruction of a finger defect with a cross-finger flap. Any additional trauma to the donor finger was an exclusion criterion. Split thickness skin grafts were employed for donor site closure in 13 cases, full thickness skin grafts were used in 10 cases. Follow-up time averaged 83 months. Active and passive total range of motion of the donor finger and maximal pinch grip strength in kilopascals were measured. Both parameters were compared to the corresponding finger of the other hand. The donor site scar was evaluated for instability and pain in the donor finger was determined subjectively with a visual analogue scale. Cold intolerance and the cosmetic appearance of the donor site were also assessed. Active total range of motion of the donor fingers averaged 156 degrees . Average active total range of motion of the contralateral control fingers was 173.6 degrees . There was a significant difference between the donor fingers and the control fingers (p = 0.03) but not between split thickness and full thickness grafted donor sites (p = 0.91). Grip strength was significantly impaired in the donor fingers (p = 0.03), but there was no significant difference between split thickness and full thickness grafted donor sites. Subjective cosmetic evaluation by the patients revealed significantly better results for full thickness grafted donor sites. Donor finger pain averaged 2.4 with a range of 0-8. Five of the 13 patients with split thickness grafted donor sites and two of the 10 patients with full thickness grafted donor sites mentioned cold intolerance. In conclusion, the cross-finger flap is a secure and valuable option. There is, however, significant donor site morbidity. Our results suggest that alternative solutions should also be considered and if a cross-finger flap is employed, donor sites should be closed with full thickness grafts.
由于相关文献稀缺，本研究旨在评估交叉手指皮瓣供区的并发症。该研究纳入了23例采用交叉手指皮瓣修复手指缺损的患者。供指的任何额外创伤均为排除标准。13例患者的供区采用中厚皮片移植闭合，10例采用全厚皮片移植。随访时间平均为83个月。测量供指的主动和被动总活动度以及以千帕为单位的最大捏力。将这两个参数与对侧相应手指进行比较。评估供区瘢痕的稳定性，并通过视觉模拟评分主观确定供指的疼痛程度。还评估了供区的冷不耐受情况和外观。供指的主动总活动度平均为156度。对侧对照手指的平均主动总活动度为173.6度。供指与对照手指之间存在显著差异（p = 0.03），但中厚皮片移植供区与全厚皮片移植供区之间无显著差异（p = 0.91）。供指的握力明显受损（p = 0.03），但中厚皮片移植供区与全厚皮片移植供区之间无显著差异。患者的主观外观评估显示，全厚皮片移植供区的效果明显更好。供指疼痛平均为2.4，范围为0至8。13例中厚皮片移植供区的患者中有5例，10例全厚皮片移植供区的患者中有2例提到有冷不耐受情况。总之，交叉手指皮瓣是一种安全且有价值的选择。然而，供区存在明显的并发症。我们的结果表明，也应考虑其他解决方案，如果采用交叉手指皮瓣，供区应采用全厚皮片闭合。
