摘要
目的 寻找手部大范围多元组织毁损后组织修复及功能重建的最佳方法。方法 1990年 1月～1999年 6月 ,采用急症 (33例 )、亚急症 (伤后三天内 ,2 6例 )吻合血管的组织移植或复合组织移植的方法一期修复毁损组织并重建手部功能。对手部桡侧的再造采用皮瓣与足趾组合时于皮瓣局部打孔的方法将再造拇指引出 ,解决虎口瘢痕挛缩 ;在游离第二足趾的同时游离伸口止母、伸趾短肌或口止母短展肌组合移植重建再造拇指对掌功能 ;对受区无可供吻合血管或可供吻合血管数量不足 ,采用 Y型静脉倒置、顺置搭桥或母体血管分支搭桥的方法予以解决。临床应用 5 9例中组合组织移植 5 1例 ,复合组织移植 4例 ,腕掌及手指离断再植的同时进行组织移植 4例。结果 12 0个移植组织全部成活 ,无一例感染及坏死 ,手部功能均获得良好恢复。结论 采用急症。
Objective\ To investigate a clinical method in repairing destructive hand injury and reconstructing hand function in early stage. Methods\ From January 1990 to June 1999, composite tissue transplantation was used to repair destructive hand damage and reconstruct hand function with vascular anastomosis in emergency (33 cases) or subemergency (126 cases). For the radial damage, combined flaps with toes was used to treat cicatricial contracture of thumb web space. Opposing function of thumb was reconstructed by combined transplantation of short extensor muscle of great toe, short extensor muscle of toes or short abductor muscle of great toe in the same time of freeing the second toe. For no or deficient anastomosing vessles in donor site, “Y” —shaped reversal vein, anterograde bridging, or branches bridging of host vessels were applied. Results\ All of tissue transplantation were survived, including combined tissue transplantation in 51 cases, composite tissue transplantation in 4 cases, tissue transplantation after replantation of severed wrist and finger in 4 cases, there were no infection or necrosis in all cases, and hand function recovered well. Conclusion\ It is an ideal procedure to repair destructive hand injury and reconstruct hand function by combined or composite tissue transplantation with vascular anastomosis in emergency or subemergency.
出处
《中国修复重建外科杂志》
CAS
CSCD
2000年第4期193-196,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
手外伤
毁损性
修复
功能重建
Hand Destructive injury Repair Function reconstruction
