Alagoz M Sahin, Uysal Cagri A, Kerem Metin, Sensoz Omer
Department of Plastic and Reconstructive Surgery, Kocaeli University Faculty of Medicine, Turkey.
Ann Plast Surg. 2006 Mar;56(3):279-83. doi: 10.1097/01.sap.0000200086.24613.da.
The main aim of the treatment of fingertip amputations with no indication of replantation was to establish the functional and esthetic construction. The critical point in the utilization of the bone and nail tissue as a graft for reconstruction was to choose a flap that is sufficiently vascular to nourish these grafts. We have performed homodigital artery flaps to cover the bone and nailbed grafts taken from the amputation to restore fingertip function with an acceptable result. The venous insufficiency with the increased probability in flap failure should be taken into consideration. We proposed the preservation of some amount of soft tissue around the vascular pedicle to overcome the venous insufficiency and in our point of view, digital artery sacrifice was worth it to preserve the length of the finger and the esthetic nail appearance.
对于无再植指征的指尖离断伤，治疗的主要目的是构建功能和美观的外形。将骨和甲床组织作为移植物用于重建的关键在于选择血供充足的皮瓣以滋养这些移植物。我们采用同指动脉皮瓣覆盖取自离断伤处的骨和甲床移植物，以恢复指尖功能，效果尚可。应考虑到静脉回流不足会增加皮瓣坏死的可能性。我们建议在血管蒂周围保留一定量的软组织以克服静脉回流不足，并且在我们看来，牺牲指动脉以保留手指长度和美观的指甲外观是值得的。
