Suga Hirotaka, Mukouda Masashi
Department of Plastic and Reconstructive Surgery, Asahi General Hospital, Chiba, Japan.
Ann Plast Surg. 2005 Sep;55(3):272-5. doi: 10.1097/01.sap.0000174356.70048.b8.
We reviewed the clinical features of 16 patients who underwent surgery for subungual exostosis, focusing on postoperative deformity of the nail. In 7 patients, the lesion did not destroy the nail bed and was excised with a fish-mouth-type incision. In 9 patients, the lesion destroyed the nail bed and was excised with a direct approach. In 5 of the 9 patients, artificial skin was applied after excision of the tumor because the defect of the nail bed was large. Good postoperative appearance of the nail was obtained by a fish-mouth-type incision when the tumor did not destroy the nail bed, although 2 patients had local recurrence. Onycholysis occurred postoperatively when the tumor destroyed the nail bed and the defect of the nail bed was large after excision of the tumor. Secondary nail bed reconstruction may be indicated in such cases with postoperative deformity of the nail.
我们回顾了16例接受甲下外生骨疣手术患者的临床特征，重点关注术后指甲畸形情况。7例患者的病变未破坏甲床，采用鱼口型切口切除。9例患者的病变破坏了甲床，采用直接入路切除。9例患者中有5例在肿瘤切除后因甲床缺损较大而应用了人工皮肤。当肿瘤未破坏甲床时，采用鱼口型切口术后指甲外观良好，尽管有2例患者出现局部复发。当肿瘤破坏甲床且肿瘤切除后甲床缺损较大时，术后会发生甲分离。对于此类术后指甲畸形的病例，可能需要进行二期甲床重建。
