Tomioka Yoko Katsuragi, Narushima Mitsunaga, Yamashita Shuji, Ito Asuka, Okazaki Mutsumi
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2020 Dec 17;8(12):e3292. doi: 10.1097/GOX.0000000000003292. eCollection 2020 Dec.
Syndactyly of the hand is commonly treated using local flaps with skin grafts; however, contractures and/or pigmentation pose a challenge, requiring repeated surgery. Here, we describe a case of a 1-year-old boy who underwent web transplantation for syndactyly. To the best of our knowledge, no "web for web" transplantations have been documented in pediatric literature. Because the patient had an "extra" web space, functional and aesthetic reconstruction was performed with careful preparation. The vascular pattern was assessed using high-resolution ultrasonography. The flap was harvested under a microscope, intravascular stenting was performed for secure anastomosis, and the adequacy of circulation in the flap was verified using the indocyanine green test. Each technique in the procedure used by us contributed to making the microsurgery safer. The present case suggests that "web for web" is a favorable treatment option for some cases, although these would be limited in number.
手部并指畸形通常采用带皮瓣的局部皮瓣进行治疗;然而,挛缩和/或色素沉着带来了挑战,需要反复手术。在此,我们描述了一例1岁男孩接受并指畸形蹼移植的病例。据我们所知,儿科文献中尚无“蹼对蹼”移植的记录。由于该患者有一个“额外”的蹼间隙,因此在精心准备后进行了功能和美学重建。使用高分辨率超声评估血管模式。在显微镜下切取皮瓣,进行血管内支架置入以确保吻合,并用吲哚菁绿试验验证皮瓣的血液循环是否充足。我们在该手术中使用的每种技术都有助于使显微手术更安全。本病例表明,“蹼对蹼”对于某些病例是一种有利的治疗选择,尽管此类病例数量有限。