摘要
目的探讨分析原位回植结合带蒂皮瓣-皮片用于手部皮肤不完全撕脱伤修复中的效果。方法选取2022年2月至2025年5月河南中医药大学人民医院收治的接受修复治疗的78例手部皮肤不完全撕脱伤患者,均接受原位回植结合带蒂皮瓣-皮片治疗,观察分析患者皮肤成活情况、手功能恢复情况、并发症发生率、生活质量及满意度。结果78例手部皮肤不完全撕脱伤患者接受原位回植结合带蒂皮瓣-皮片治疗后,撕脱皮肤全部一期成活,成活优良率为93.59%(73/78);5例患者发生远端皮缘部分坏死,经加强换药处理后均实现甲级愈合。术后3个月患者手指总活动度(TAM)评分和手感觉功能分级较术前明显改善,差异有统计学意义(P<0.05)。术后2例发生静脉危象,经及时处理后皮瓣恢复正常,无感染或全层坏死病例。术后3个月患者心理、躯体、社会及物质功能评分均较术前明显提升,差异有统计学意义(P<0.05)。术后3个月满意度调查显示,患者满意度94.87%(74/78)。结论原位回植结合带蒂皮瓣-皮片用于手部皮肤不完全撕脱伤修复中能获得确切的治疗效果,可促进患者手功能改善及生活质量提升,且并发症少、患者满意度高。
Objective To explore and analyze the effect of in situ replantation combined with pedicle flap skin graft in the repair of incomplete skin avulsion injuries in the hand.Methods From February 2022 to May 2025,78 patients with incomplete avulsion of hand skin who received repair treatment in our hospital were selected.All patients received in-situ transplantation combined with pedicle flap skin graft treatment.The survival status of the patients'skin,recovery of hand function,incidence of complications,quality of life,and satisfaction were observed and analyzed.Results After 78 patients with incomplete avulsion injuries of hand skin received orthotopic replantation combined with pedicled flaps and skin grafts,all the avulsion skin survived in the first stage.Among them,62 cases(79.49%)had an excellent survival rate,11 cases(14.10%)had a good survival rate,5 cases(6.41%)had a fair survival rate,and the excellent and good survival rate of the skin was 93.59%.Partial necrosis of the distal skin margin occurred in 5 patients.After enhanced dressing change treatment,all achieved Grade A healing.Three months after the operation,the total finger range of motion(TAM)score and hand sensory function classification of the patients were significantly improved compared with those before the operation,and the difference was statistically significant(P<0.05).After the operation,venous crisis occurred in 2 cases(2.56%).After timely treatment,the flaps returned to normal,and there were no cases of infection or full-thickness necrosis.Three months after the operation,the scores of psychological,physical,social and material functions of the patients were significantly improved compared with those before the operation,and the difference was statistically significant(P<0.05).The satisfaction survey three months after the operation showed that 59 patients(75.64%)were very satisfied,15 patients(19.23%)were generally satisfied,and 4 patients(5.13%)were dissatisfied,with a satisfaction rate of 94.87%.Conclusions flfiIn situ transplantation combined with pedicle flap skin graft can achieve definite therapeutic effects in the repair of incomplete skin avulsion injuries in the hand,promote the improvement of hand function and quality of life in patients,and have fewer complications and high patient satisfaction.
作者
张宇航
佘恒
高军胜
张耀华
姚帅辉
崔金雷
ZHANG Yuhang;SHE Heng;GAO Junsheng;ZHANG Yaohua;YAO Shuaihui;CUI Jinlei(The first Department of Orthopedics,The Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People's Hospital),Zhengzhou 450000,Henan Province,China)
出处
《中国医疗美容》
2025年第11期80-85,共6页
China Medical Cosmetology
关键词
原位回植
带蒂皮瓣-皮片
手部皮肤不完全撕脱伤
手功能
并发症
in situ replanting
pedicled skin flap-skin graft
incomplete tearing injury of hand skin
hand function
complication
