Hassanpour Seyed-Esmail, Hosseini Seyed Nejat, Abdolzadeh Madjid
Department of Hand and Plastic, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tech Hand Up Extrem Surg. 2011 Jun;15(2):94-8. doi: 10.1097/BTH.0b013e3181f60dc0.
The main aim of the treatment in fingertip amputations is to establish the functional and aesthetic construction of the fingertip. The aim of this study is to discuss how to use purse-string suture as a complementary technique accompanying conventional flaps repair in fingertip amputation. Fifty-four patients with fingertip amputations on the nail bed referred to our center for fingertip reconstruction. From which 41 patients who had at least one-third of their nail remained (to preserve the nail) were chosen to undergo this new technique. Patient's satisfaction of the achieved functional results (in case of pain and motion) was as follows: 32 responded excellent, 8 good, and 1 fair. Also, patient's satisfaction of the achieved aesthetic results were Excellent = 7 and Good = 2 in females (n = 9) and Excellent = 19, Good = 7 and Fair = 6 in males (n = 32). 93% (38 patients) of the patients had two-point discriminationof less than 3 mm. No flap necrosis was observed in this study. The flap donor site was covered by primary closure (in 24 cases), secondary intention (in 11 cases), and skin graft (in 6 cases). The nail and finger contour are important for achieving a satisfying aesthetic and functional result. We believe that this new complementary technique could be an easy way for reaching this end. It is recommended that this technique be applied to all fingertip injuries to preserve the nail.
指尖离断伤治疗的主要目的是重建指尖的功能和美观。本研究旨在探讨如何将荷包缝合作为一种辅助技术，与传统皮瓣修复术联合用于指尖离断伤的治疗。54例甲床指尖离断伤患者到我院中心进行指尖重建。从中选取41例至少保留三分之一指甲（以保留指甲）的患者接受这项新技术治疗。患者对所取得的功能结果（疼痛和活动方面）的满意度如下：32例评价为优，8例为良，1例为差。此外，患者对所取得的美学效果的满意度为：女性（n = 9）中优= 7例，良= 2例；男性（n = 32）中优= 19例，良= 7例，差= 6例。93%（38例）患者的两点辨别觉小于3 mm。本研究中未观察到皮瓣坏死。皮瓣供区采用一期缝合（24例）、二期愈合（11例）和植皮（6例）覆盖。指甲和手指外形对于获得满意的美学和功能效果很重要。我们认为这种新的辅助技术可能是实现这一目标的简便方法。建议将该技术应用于所有指尖损伤以保留指甲。
