Lu Yefeng, Shen Rongrong, Zhou Junhui, Li Jiliang, Huang Yinwei
Department of Hand and Foot Microsurgery, Yuyao People's Hospital of Zhejiang Province Ningbo, Zhejiang Province, China.
Department of Anesthesia, Yuyao People's Hospital of Zhejiang Province Ningbo, Zhejiang Province, China.
Am J Transl Res. 2022 Oct 15;14(10):7156-7163. eCollection 2022.
To investigate the effect of transverse wrist crease perforator flap repair on sensory nerve function, survival of flap, hand function, hand appearance and satisfaction rate in patients with soft tissue defect of fingers.
This retrospective study was performed in 30 patients admitted to the Hand and Foot Microsurgery Department of our hospital between January 2018 and December 2020. These patients were divided into to the control group and the experimental group (15 patients for each group) according to the operative methods. Patients in the control group underwent abdominal flap repair, while patients in the experimental group received transverse wrist crease perforator flap repair. Intraoperative parameters, sensory nerve function, function of finger reconstruction, survival rate of skin flap, degree of scar contracture and flap bloatedness, DASH score, two-point discrimination and satisfaction rate were compared between the two groups.
Compared with the control group, the operative time in the experiment group was obviously decreased (P<0.05). There was no difference in amount of bleeding between the two groups. The proportion of sensory nerve function grade S3+ and S4 in the experimental group was significantly increased in contrast to the control group (P<0.05). The total excellent and good rate in function of finger reconstruction in the experiment group was significantly higher than that in the control group, while no difference was found in the survival rate of skin flap and scar contracture between the two groups. Compared with the control group, DASH score, two-point discrimination distance, and degree of flap bloatedness in the experiment group were significantly reduced and the patients' satisfaction rate in the experiment group was remarkably increased (all P<0.05).
Transverse wrist crease perforator flap repair plays a critical role in reducing operative time, improving sensory nerve function and recovery of hand function, and alleviating flap bloatedness. It is an optimal treatment for soft tissues defect of fingers.
探讨腕横纹穿支皮瓣修复术对指部软组织缺损患者感觉神经功能、皮瓣存活情况、手部功能、手部外观及满意度的影响。
本回顾性研究纳入了2018年1月至2020年12月期间我院手足显微外科收治的30例患者。根据手术方式将患者分为对照组和试验组（每组15例）。对照组患者接受腹部皮瓣修复，试验组患者接受腕横纹穿支皮瓣修复。比较两组患者的术中参数、感觉神经功能、手指再造功能、皮瓣成活率、瘢痕挛缩程度和皮瓣臃肿程度、DASH评分、两点辨别觉及满意度。
与对照组相比，试验组手术时间明显缩短（P<0.05）。两组出血量差异无统计学意义。试验组感觉神经功能S3+及S4级比例较对照组显著增加（P<0.05）。试验组手指再造功能总优良率显著高于对照组，而两组皮瓣成活率和瘢痕挛缩情况差异无统计学意义。与对照组相比，试验组DASH评分、两点辨别觉距离及皮瓣臃肿程度显著降低，试验组患者满意度显著提高（均P<0.05）。
腕横纹穿支皮瓣修复术在缩短手术时间、改善感觉神经功能和手部功能恢复以及减轻皮瓣臃肿方面发挥着关键作用。它是指部软组织缺损的一种最佳治疗方法。
