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題名 | Reverse Digital Arterial Island Flap for Finger Pulp Reconstrction--Experience in TSGH=利用逆行性指側島狀皮瓣來行指腹重建--三軍總醫院的經驗 |
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作者 | 唐仲奇; 周俊雄; 周聰鐸; 陳紹良; 陳錫根; 鄭天宇; 陳天牧; 王先震; Tarng, Chung-chyi; Chou, Chiuen-hsueng; Chou, Trong-duo; Chen, Shou-liang; Chen, Shyi-gen; Cheng, Tian-yen; Chen, Tim-mo; Wang, Hsian-jean; |
期刊 | 醫學研究 |
出版日期 | 19980900 |
卷期 | 19:2 1998.09[民87.09] |
頁次 | 頁95-101 |
分類號 | 416.615 |
語文 | eng |
關鍵詞 | 逆行性指側島狀皮瓣; 神經吻合; 移動性鑑別兩點間距離測驗; Reverse digital arterial island flap; Neurorraphy; Moving two-point discrimination test; |
中文摘要 | 逆行性指側島狀皮瓣通常應用來做為指腹重建,此步驟簡單而有效。而經由神經吻合之皮瓣,也就是切斷手指背側神經之表淺感覺枝,使之包含於皮瓣中,於皮瓣覆蓋指腹後,能經由顯術手術之方式將此神經枝與對側之指神經行吻合,希望能藉此步驟來增進指腹感覺恢復程度。 我們統計目前本院所有接受此項手術之病人,共有九位。其中有四位接受皮瓣覆蓋及神經吻合之步驟, 其重建後指腹之感覺恢復以移動性鑑別兩點間距離測驗(moving two-point discrimination test)以及感覺恢復指數(sensory recovery score)來評估。由我們有限的經驗可知,此皮瓣有維持指腹之飽滿度,縮短住院時間,一個階段手術,良好的感覺恢復以及減少皮瓣供應區之後遺症等優點,且經由神經吻合之皮瓣感覺神經恢復優於傳統皮瓣。 |
英文摘要 | The reverse digital arterial island flap is usually used for finger pulp reconstruction. Endo et al first described the variant procedure, innervated island flap. (1992). The superficial sensory branch of the dorsal digital nerve is sacrificed including it within the flap, then it is reanastomosed to the digital nerve stump on the affected side in order to improve sensory recovery of the pulp, with excellent results (one-sided neurography). We summarized nine finger pulp reconstruction patients in our section and the follow-up time was at least six months after the procedure. All the patients' flaps survived completely, with out other surgical complications. We analyzed the sensory recovery of post-reconstructive pulps by using a moving two-point discrimination test (M-2PD test) and sensory recovery score (SRS). In our limited experience, the flap has many advantages including: bulky pulp volume maintenance, shorter hospitalization, single stage operation, good sensory recovery and less donor site morbidity. The innervated flap had better sensory recovery than the non-innervated flap. |
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