摘要
目的评价真皮浅筋膜复合组织反转游离移植再造甲床手术的临床疗效及可行性,为临床解决甲床再造提供更安全、更新颖、更合适的手术方式。方法选择2016年7月—2018年6月间东营市人民医院手足外科收治的外伤致甲床缺损患者35例40指纳入试验组,均使用真皮浅筋膜复合组织反转游离移植再造甲床的手术方案;另取2014年7月—2016年6月外伤致甲床缺损患者33例33指资料作为对照组,使用断层甲床游离移植再造甲床术,比较2组患者术后指甲生长情况和并发症发生率。结果试验组患者术后指甲生长优良率与对照组比较差异无统计学意义(97.0%vs. 97.5%,χ~2=0.339,P=0.560),试验组患者再造后甲床能覆盖骨质、指甲生长完整、色泽度接近对照组患者;试验组并发症发生率显著低于对照组,差异有统计学意义(0 vs. 15. 1%,χ~2=4. 348,P=0. 037);试验组的复合组织供区未出现任何不良后果,全部一期愈合。结论真皮浅筋膜复合组织反转游离移植修复再造甲床术能恢复指甲的外形与功能,且手术并发症更少。
Objective To evaluate the clinical efficacy and feasibility of nail bed reconstruction with reversed free dermal and superficial fascia composite tissue transplantation, and to provide a safer, newer and more appropriate surgical method for nail bed reconstruction. Methods From July 2016 to June 2018, 35 patients with nail bed defect caused by hand and foot trauma in Dongying People’s Hospital were enrolled in the experimental group with 40 fingers, all of which were reconstructed by reverse free transplantation of superfic ial dermal fascia composite tissue. 33 fingers of 33 patients with nail bed defect caused by trauma from July 2014 to June 2016 were taken as the control group and reconstructed nail bed by free transplantation of split nail bed. The growth of nails and the incidence of complications were compared between the two groups. Results There was no significant difference in the rate of excellent nail growth between the experimental group and the control group(97.0% vs. 97.5%,χ^2=0.339,P= 0.560). In the experimental group, the nail bed can cover the bone, the nail grows intact, and the color degree is close to the control group. The incidence of complications in the experimental group was significantly lower than that in the control group, and the difference was statistically significant(0% vs. 15. 1%,χ^2 =4.348,P = 0. 037). The composite tissue donor site of the experimental group did not show any adverse consequences, and all of them healed. Conclusion Superficial dermis and fascia composite tissue reverse free transplantation for nail bed reconstruction can restore the shape and function of nails, and has fewer complications.
作者
孙同新
杨代
房波
宋桂先
闫新海
孙书海
SUN Tongxin;YANG Dai;FANG Bo;SONG Guixian;YAN Xinhai;SUN Shuhai(Department of Hand and Foot Surgery,Dongying People's Hospital,Shandong Province,Dongying 257091,China)
出处
《疑难病杂志》
CAS
2019年第5期473-476,共4页
Chinese Journal of Difficult and Complicated Cases
基金
山东省自然科学基金面上项目(ZR201603180116)
关键词
甲床缺损
再造甲床术
真皮浅盘膜复合组织
反转游离移植
Nail bed defect
Reconstruction of nail bed
Composite tissue of superficial disc membrane of dermis
Reverse free transplantation
