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脱细胞真皮基质治疗手指脱套伤:功能和美学效果。

Treatment of finger degloving injury with acellular dermal matrices: Functional and aesthetic results.

机构信息

Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, p.zza Giulio Cesare 11, 70124 Bari, Italy.

Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, p.zza Giulio Cesare 11, 70124 Bari, Italy.

出版信息

J Plast Reconstr Aesthet Surg. 2019 Sep;72(9):1509-1517. doi: 10.1016/j.bjps.2019.05.029. Epub 2019 May 22.

Abstract

INTRODUCTION

Finger degloving injuries (FDIs) represent a challenge in hand surgery. When replantation is not possible, several techniques including loco-regional flaps, pocket abdominal flaps and free flaps have been described as methods to provide skin cover and avoid finger shortening. The aim of this study is to present our experience with acellular dermal matrices (ADMs) in the treatment of FDI.

MATERIALS AND METHODS

We retrospectively reviewed the charts of 18 patients who presented with FDI and were treated with ADM between December 2015 and July 2017. Surgical outcomes including complications were analysed, and patient-centred assessments were performed at 12 months of follow-up.

RESULTS

The follow-up period ranged from 10 to 20 months. All patients showed good integration and vascularisation of the ADM. All the fingers covered with ADM were firm and soft, with a slim and satisfactory appearance at a mean follow-up of 12 months. No limitations in tendon sliding were observed at dynamic sonography one year after surgery.

CONCLUSION

ADMs could be regarded as a viable option when dealing with FDIs, if replantation is not possible and finger length is to be preserved. On the basis of these results, the surgical treatment of FDI with ADM is a viable option that produces good functional outcomes and cosmetic appearance.

摘要

简介

手指套状撕脱伤(FDIs)对手外科来说是一个挑战。当再植术不可行时,已经描述了几种技术,包括局部皮瓣、袋状腹部皮瓣和游离皮瓣,这些技术可提供皮肤覆盖并避免手指缩短。本研究旨在介绍我们在 FDIs 治疗中使用脱细胞真皮基质(ADM)的经验。

材料和方法

我们回顾性分析了 2015 年 12 月至 2017 年 7 月期间因 FDIs 接受 ADM 治疗的 18 例患者的病历。分析了手术结果,包括并发症,并在随访 12 个月时进行了以患者为中心的评估。

结果

随访时间为 10 至 20 个月。所有患者的 ADM 均显示出良好的整合和血管化。所有用 ADM 覆盖的手指在 12 个月的平均随访期内均坚固且柔软,外观纤细,令人满意。术后 1 年动态超声检查未见肌腱滑动受限。

结论

如果再植术不可行且需要保留手指长度,ADM 可作为 FDIs 的可行选择。基于这些结果,使用 ADM 治疗 FDIs 的手术治疗是一种可行的选择,可产生良好的功能和美容效果。

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