Department of Plastic and Reconstructive Surgery, Queen Elizabeth Hospital, Birmingham, UK
Department of Plastic and Reconstructive Surgery, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.
BMJ Case Rep. 2020 Sep 22;13(9):e236253. doi: 10.1136/bcr-2020-236253.
Nail bed avulsion injuries often require reconstruction, particularly in cases where the avulsed fragment is lost. We describe a simple way to reconstruct a large nail bed defect, with no donor site. A 13-year-old boy with a hypoplastic left heart and autism accidentally sustained a left little distal phalanx injury with an avulsion of 60% of the nail bed, exposing the distal phalanx. This boy had a history of poor compliance, qualifying the need to find a technique that would minimise operative time and dressing changes. As such, it was elected to use an acellular dermal matrix (ADM) (Matriderm) as a one-step reconstruction. Signs of vascularisation of the ADM were noted at 2 weeks, and 3-month follow-up demonstrated integration, with normal nail growth. We found that Matriderm was able to support the regeneration of a full thickness wound in a simple one-step procedure.
甲床撕脱伤常需要重建，特别是撕脱的碎片丢失的情况下。我们描述了一种简单的方法来重建一个大的甲床缺损，且无需供区。一名 13 岁男孩患有左心发育不全和自闭症，意外地遭受了左手小远节指骨损伤，甲床撕脱 60%，远节指骨外露。这个男孩既往依从性差，需要找到一种可以尽量减少手术时间和换药次数的技术。因此，我们选择使用脱细胞真皮基质 (ADM) (Matriderm) 作为一步法重建。在第 2 周时观察到 ADM 的血管化迹象，3 个月的随访显示了整合，有正常的指甲生长。我们发现 Matriderm 能够在一个简单的一步法中支持全层伤口的再生。
