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[埃默特整形手术]

[Emmert's plastic surgery].

作者信息

Tarwnah Abdullah, De la Cruz Marlon, Tezval Mohammad

机构信息

Klinik für Unfallchirurgie, Sporttraumatologie und Handchirurgie, Klinikum Vest, Knappschaftskrankenhaus Recklinghausen, Dorstener Str. 151, 45657, Recklinghausen, Deutschland.

Klinik für Allgemein- und Viszeralchirurgie, Klinikum Vest, Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Deutschland.

出版信息

Oper Orthop Traumatol. 2024 Apr;36(2):125-131. doi: 10.1007/s00064-024-00843-z. Epub 2024 Apr 9.

Abstract

OBJECTIVE

The aim of the surgical intervention is the elimination of infections, ulceration and pain caused by ingrown nails (unguis incarnatus).

INDICATIONS

A surgical intervention is recommended for ingrown nails (the large toenail is most frequently affected) in stage III and higher (according to the Mozena classification) as well as in cases of nail plate defects and recurrences.

CONTRAINDICATIONS

In cases where a disturbance of wound healing is expected and general contraindications for surgery.

SURGICAL TECHNIQUE

The surgical approach incorporates a half-moon-shaped skin incision and a straight longitudinal nail incision. Both incisions extend to the bone. A wedge-shaped piece of tissue is removed and after thorough curettage and rinsing the wound is closed using transungual single-button sutures.

POSTOPERATIVE MANAGEMENT

Regular changes of wound dressing, relief of the affected ray by immobilization during wound healing. An antibiotic therapy is only indicated in selected cases.

RESULTS

Between 1 January 2013 and 1 January 2023 a total of 50 Emmert's plastic surgery operations (15 women and 35 men) were performed at the Klinikum Vest, Knappschaftskrankenhaus Recklinghausen. The average age of the patients was 50.6 years. The mean follow-up time was 63 months. The outcome and satisfaction of the patients were evaluated according to the self-reported foot and ankle score (SEFAS). The total point count (median value) of the evaluated SEFAS score was 44.

摘要

目的

手术干预的目的是消除嵌甲(甲内生)引起的感染、溃疡和疼痛。

适应症

对于III期及更高分期(根据莫泽纳分类)的嵌甲(大脚趾指甲最常受累)以及指甲板缺损和复发的情况,建议进行手术干预。

禁忌症

预期伤口愈合受到干扰的情况以及手术的一般禁忌症。

手术技术

手术方法包括一个半月形皮肤切口和一个纵向直的指甲切口。两个切口均延伸至骨。切除一块楔形组织,彻底刮除并冲洗伤口后,使用经甲单纽扣缝线闭合伤口。

术后管理

定期更换伤口敷料,在伤口愈合期间通过固定来减轻患趾的负担。仅在特定情况下进行抗生素治疗。

结果

2013年1月1日至2023年1月1日期间,雷克林豪森克纳普沙茨医院韦斯特临床中心共进行了50例埃默特整形手术(15名女性和35名男性)。患者的平均年龄为50.6岁。平均随访时间为63个月。根据患者自我报告的足踝评分(SEFAS)评估患者的治疗效果和满意度。评估的SEFAS评分的总积分(中位数)为44分。

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