第二趾游离显微皮瓣用于手指掌侧软组织缺损的美学与感觉功能重建。

Second toe microsurgical free-flap for aesthetic and sensory reconstruction of palmar soft tissue defects of fingers.

作者信息

Gu Jia-xiang, Regmi Subhash, Zhang Nai-chen, Liu Hong-jun, Zhang Wen-zhong, Xu Tao

机构信息

Department of Hand and Foot Surgery, Subei People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou City, Jiangsu Province, 225001, PR China.

College of Medicine, Yangzhou University, 11th Huaihai Road, Yangzhou City, Jiangsu Province, 225009, PR China.

出版信息

J Plast Reconstr Aesthet Surg. 2016 Mar;69(3):323-7. doi: 10.1016/j.bjps.2015.10.017. Epub 2015 Oct 26.

DOI:10.1016/j.bjps.2015.10.017

PMID:26546110

Abstract

OBJECTIVES

To illustrate the surgical methods and clinical efficacy of microsurgical free-flaps obtained from second toe for the reconstruction of palmar soft-tissue defect of fingers.

METHODS

We enrolled 22 patients (13 men and 9 women), who received second toe free-flap for 22 finger defects between August 2007 and July 2013. The average age was 35 years (range, 18-62 years). The average size of flap was 2.7 cm × 2.0 cm (range, 1.5 cm × 1.5 cm-3.5 cm × 2.5 cm).

RESULTS

All flaps survived well without any complications. Follow-up period ranged from 8 to 30 months (mean 15 months). The Visual Analog Scale for flap appearance (VAS flap) was ranged from 8 to 10 (average, 9.5). Based on the CISS questionnaires, 6 cases had mild cold intolerance. The average value of Michigan Hand Outcome Questionnaire (MHOQ) scoring for overall hand function was 8 (range, 5-13). The sensibility outcomes in 10 patients who underwent nerve repair were satisfactory. Average value of static two point discrimination (2PD) was 6.4 mm (range, 4-10 mm) and SWM test was 3.45 (range 2.83-4.12).

CONCLUSIONS

Second toe free micro-flap is a very useful and reliable alternative for the reconstruction of palmer soft-tissue defect of fingers.

LEVEL OF EVIDENCE

IV.

摘要

目的

阐述采用第二足趾游离皮瓣修复手指掌侧软组织缺损的手术方法及临床疗效。

方法

选取2007年8月至2013年7月期间因手指缺损接受第二足趾游离皮瓣移植的22例患者（男13例，女9例）。平均年龄35岁（18 - 62岁）。皮瓣平均大小为2.7 cm×2.0 cm（1.5 cm×1.5 cm - 3.5 cm×2.5 cm）。

结果

所有皮瓣均顺利成活，无任何并发症。随访时间8至30个月（平均15个月）。皮瓣外观视觉模拟评分（VAS皮瓣）为8至10分（平均9.5分）。根据CISS问卷，6例有轻度冷不耐受。密歇根手功能结果问卷（MHOQ）整体手功能评分平均值为8分（5 - 13分）。10例行神经修复患者的感觉功能结果满意。静态两点辨别觉（2PD）平均值为6.4 mm（4 - 10 mm），Semmes - Weinstein单纤维感觉试验（SWM）为3.45（2.83 - 4.12）。