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題 名 | 交指皮瓣在指尖受傷重建之應用 |
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作 者 | 丁效曾; 呂旭彥; 邱浩遠; 張士人; 吳瑞星; 黃耀主; 李鐵國; 羅賢益; | 書刊名 | 中華民國重建整形外科醫學會雜誌 |
卷 期 | 4:3 1995.09[民84.09] |
頁 次 | 頁183-189 |
分類號 | 416.615 |
關鍵詞 | 指尖受傷; 交指皮瓣; 有感覺交指皮瓣; Fingertip injury; Cross-finger flap; Sensate cross-finger flap; |
語 文 | 中文(Chinese) |
中文摘要 | 指尖受傷(fingertip injury)在手外傷中佔了相當的比例。在治療上,我們可以有很多選擇。對於部份血管仍然完整的例子,我們可以嘗試做斷指再接植手術(digital replantation)。對於大多數無法再接植的例子,則可以選擇其它的手術方法,包括截短縫合(shortening &repair)、植皮(skin graft)、局部皮瓣(local flap)、遠處皮瓣(distant flap)。近幾年來,我們比較常選擇交指皮瓣(cross-fingerflap),來做為指尖受傷的重建。 此種手術在不需要全身麻醉的情況下即可進行,手術時間短,約只需一個小時,術後病人不需住院,只要口服抗生素治療及在門診換藥即可。國泰醫院自1987至1994年共八年之間有293例指尖受傷的病例,其中有76個病例接受交指皮瓣手術治療。手術成功率為100,只有一個病例有小部份的皮瓣壞死(partial necrosis)。 7個病例有供皮指的問題(donor site morbidity),其中5例為植皮失敗(skin graft failure),2例為關節僵硬(joint stiffness)。在感覺功能的恢復方面,62例為無感覺交指皮瓣(Insensate cross-finger flap)通常可有保護性知覺(protective sensation)其2-PD在術後6個月為10~12mm,14例為有感覺交指皮瓣(sensate cross-finger flap)的感覺恢復較快,在術後3個月2-PD可達8~10mm,術後半年則可達7~8mm。本文乃是就手術的結果做統計,並就其優缺點與其它手術方法做比較。 |
英文摘要 | Fingertip amputation is one of the most common injuries of the hand. There are several alternatives in the reconstruction of the stump. We can try digital replantation if intact digital vessels could be identified. In most non-replantable cases, we have other choices such as shortening and primary repair, skin graft, local flap or distant flap. In our hospital, we prefer to use cross-finger flap for the reconstruction of fingertip injury, because of it's simplicity and safety. There are 293 fingertip injuries from 1987 to 1994 in Cathay General Hospital and 76 cases received cross-finger flap reconstruction. The successful rate was 100% except partial flap necrosis of one case. Donor site morbidity was noted in 7 cases, five cases were skin graft failure, the other two were joint stiffness. In 62 insensate cross-finger flap, protective sensation could be obtained, the 2-PD reached 10-12 mm in 6 months post-operatively. In 14 sensate cross-finger flap, early recovery of sensation was obtained, the 2-PD reached 8-10 mm in 3 months and 7-8 mm in 6 months postoperatively. Sensate cross-finger flap seems to be the most ideal to obtain more satisfactory result of finger tip injury. |
本系統中英文摘要資訊取自各篇刊載內容。