Tanagho Andy, Beaumont Jan, Thomas Roshin
Dumfries and Galloway Royal Infirmary, Dumfries, UK.
J Hand Microsurg. 2015 Dec;7(2):317-9. doi: 10.1007/s12593-015-0208-0. Epub 2015 Oct 25.
Dupuytren's disease with severe finger contractures and recurrent contractures following previous surgery often have extensive skin involvement. In these severe cases, excision of the diseased chord along with the involved skin is a good option to reduce the risk of recurrance. The resulting skin defect can be covered with a full thickness skin graft (FTSG) or a cross finger flap. Cross finger flaps have donor finger morbidity and hence a full thickness graft is usually preferred. The FTSG extending to the midlateral margins on both sides of the finger reduces the risk of joint contracture due to graft shrinkage. Once the FTSG is sutured in place, the standard practice is to compress and secure the graft to its recipient bed with a tie-over dressing and this can be time consuming. We present a simple dressing technique to secure the FTSG without the need for a tie-over dressing.
患有严重手指挛缩且在先前手术后复发挛缩的杜普伊特伦挛缩病通常有广泛的皮肤受累。在这些严重病例中,切除病变索带及受累皮肤是降低复发风险的一个好选择。由此产生的皮肤缺损可用全厚皮片(FTSG)或交叉手指皮瓣覆盖。交叉手指皮瓣会导致供指发病,因此通常首选全厚皮片。延伸至手指两侧中外侧边缘的全厚皮片可降低因皮片收缩导致关节挛缩的风险。一旦全厚皮片缝合到位,标准做法是用包扎敷料将皮片压缩并固定在受区创面上,这可能很耗时。我们提出一种简单的包扎技术,无需包扎敷料即可固定全厚皮片。