Hoigné D, Hug U, Schürch M, Meoli M, von Wartburg U
Division of Hand and Plastic Surgery, Cantonal Hospital, Lucerne, Switzerland
Division of Hand and Plastic Surgery, Cantonal Hospital, Lucerne, Switzerland.
J Hand Surg Eur Vol. 2014 Jun;39(5):505-9. doi: 10.1177/1753193413489639. Epub 2013 May 21.
Nineteen fingertip amputations with exposed bone were treated with a semi-occlusive dressing. The quantity and quality of the regenerated soft tissue was examined. In all 19 fingers there was sufficient uncomplicated healing such that secondary surgical procedures were not needed. At follow-up 6-18 months after the injury, soft tissue thickness around the bone of the distal phalanx measured 6.0 mm (SD 1.6) on the palmar aspect (opposite side 7.0 mm (SD 0.8)) and 4.2 mm (SD 1.7) distally (opposite side 4.5 mm (SD 0.8)). The two-point discrimination was 4 mm (SD 2) (opposite side 3 mm (SD 1)). The skin healed almost without scarring and the dermal ridges reformed. The regeneration of the soft tissue thickness to almost 90% of its former extent is higher than we expected.
19例伴有骨质外露的指尖离断伤采用半封闭敷料治疗。对再生软组织的数量和质量进行了检查。所有19根手指均实现了充分且未出现并发症的愈合,因此无需进行二期外科手术。在受伤后6 - 18个月的随访中,远节指骨掌侧(对侧为7.0 mm(标准差0.8))的骨周围软组织厚度为6.0 mm(标准差1.6),远侧为4.2 mm(标准差1.7)(对侧为4.5 mm(标准差0.8))。两点辨别觉为4 mm(标准差2)(对侧为3 mm(标准差1))。皮肤愈合后几乎不留瘢痕,皮嵴重新形成。软组织厚度再生至几乎为原来范围的90%,这比我们预期的要高。