中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (18): 3385-3388.doi: 10.3969/j.issn.1673-8225.2010.18.038

• 器官移植临床实践 clinical practice of organ transplantation • 上一篇    下一篇

三种不同组织移植方法一期修复外伤性甲床缺损：40例51指甲床的随访比较

张  阳，周  辉，张  燕，王旭良，张  雁，钟卫民，陈  柯，周海鹰，李  芳，舒灵霞   

  1. 解放军第四五八医院整形外科，广东省广州市  510602
  • 出版日期:2010-04-30 发布日期:2010-04-30
  • 作者简介:张 阳☆，男，1972年生，陕西省西安市人，汉族，1995年解放军第四军医大学毕业，博士，副主任医师，主要从事整形外科的临床研究。 greendoctor@sohu.com

Three different tissue transplantation methods for repairing traumatic nail bed defects in one stage: A follow-up comparison among 40 cases with 51 finger nail beds

Zhang Yang, Zhou Hui, Zhang Yan, Wang Xu-liang, Zhang Yan, Zhong Wei-min, Chen Ke, Zhou Hai-ying, Li Fang, Shu Ling-xia   

  1. Department of Plastic Surgery, the 458th Hospital of Chinese PLA, Guangzhou  510602, Guangdong Province, China
  • Online:2010-04-30 Published:2010-04-30
  • About author:Zhang Yang☆, Doctor, Associate chief physician, Department of Plastic Surgery, the 458th Hospital of Chinese PLA, Guangzhou 510602, Guangdong Province, China greendoctor@sohu.com

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摘要：

背景：指端皮肤和软组织缺损合并甲床部分缺失理想的治疗方法以术后尽可能地保留手指的长度、恢复指端外形及具有良好的感觉为目的，以往的治疗方法包括指骨缩短或皮瓣覆盖创面，各有不足之处。
目的：比较不同治疗方法一期修复甲床缺损的效果，综合评价其功能恢复情况。
方法：选择2002-12/2009-02在解放军第四五八医院整形外科就诊的40例51指甲床缺损就诊者。在骨膜存在条件下，当甲床缺损≥ 5 mm，但小于同指甲床面积的1/3者，采用同指中厚断层残留甲床移植；当甲床缺损在大于同指甲床面积的1/3者或合并两指甲床缺损时，采用第一、二足趾为供区；当末节指骨骨膜缺损时，甲床缺损面积在1/3~1/2范围内，采用有血供的断层甲床组织瓣局部转移。伤者术后随访，观察指甲形态和手指功能。
结果与结论：经过1个月~2年随访，平均6个月。优良36例44指，即86.3%的病例获得良好的外形及对捏、持物功能。提示根据不同伤情采用对应甲床修复方法可达到一期修复甲床缺损的目的，恢复指甲形态和手指功能。

关键词: 甲床缺损, 修复, 一期, 移植, 组织移植

Abstract:

BACKGROUND: Treatment methods for defects of fingertip skin or soft tissue combined with partial deletion bed include the phalanx shortening or flap coverage of wounds, each with shortcomings.
OBJECTIVE: To investigate the efficacy of repairing finger nail bed defects by different treatments in one stage, and to evaluate the functional recovery of nail beds comprehensively.
METHODS: From December 2002 to February 2009, 51 fingers with nail bed defects in 40 patients (11 thumbs, 22 index fingers, 14 middle fingers, 4 ring fingers) were repaired. Under the situation that the periosteum exist, when the area of nail bed defect area was less than one third of the nail, the graft was taken from the same finger. If the area of nail bed defects were larger than one third of the nail or two nail bed defects, the grafts were taken from the nail beds of 1st or 2nd toes. Under the situation that the periosteum nonexist, when the area of nail bed defect area was less than one half and more than one third of the nail, the split tissue flap was transferred from the same finger. The finger appearance and functions were observed in the follow-up.
RESULTS AND CONCLUSION: All patients were followed up from 1 month to 2 years with an average of 6 months, 86.3% grafts survived very well, no pain, no infection and obvious deformed growth of nail were found. It revealed that using different treatment to repair nail bed defect is available. The grafted nail can grow in good appearance, and finger can act in good function.

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