The Anatomical Study And Clinical Application Of Miniature Flaps Repair Of Skin Avulsion At Fingers

Objective:To introduce a surgical procedure for repair of skin avulsion at fingers,and investigate the clinical value of double miniature flaps.Skin avulsion at fingers in clinical practice is very common,which is a serious and difficult to deal with the trauma, how to fix a reasonable hand surgery has been troubled workers problems.Repair of finger skin defect in general from the following four areas to measure the merits of its surgical techniques: recovery of motor function, sensory function recovery after surgery, as well as the appearance of the destruction of healthy tissue. At present, in clinical it is frequently used chest tube, abdominal pocket flap or toe thumb, such as a flap repair methods, these surgical patients to choose, while referring to the length of a reservation, but there are obvious flaws. Application of the chest and abdominal tube flap pocket, after the look and feel of a finger motor function is extremely poor and helpless is a choice; 1980 Morrison first reported a thumb toe flap application, the technique of thumb reconstruction good shape, but the restoration of sensory function is not reliable, especially for the more serious damage to the toes. Hand miniature flaps includes index finger dorsal island flap, dorsal metacarpal artery flap, flap artery anterograde and retrograde arterial flap means and so on, it is generally used to repair skin avulsion at fingers unilateral. Application of these flaps in the repair of finger together two sets of skin avulsion for repair of finger's soft tissue defect provided a good method. This method cuts the flap blood supply good quality affordable, wearable, non-bloated, the surgery is not difficult, and the reconstruction of areas affected by sensory function, so it is an ideal method to repair soft tissue defects of the fingers.Application of miniature flaps repair of the skin avulsion at fingers, you can complete an operation to protect the fingers of early functional exercises, to maximize the restoration of motor function of fingers; the application of pedicle skin contains nerve tissue, can be fully restored risk refers to the sensory function, pinch grip for the fingers to complete the functional significance; flap thin, color and texture refers to the original skin and suffering from similar appearance after repair compared; anatomical miniature flaps donor site on the organization does not have any obvious damage. Therefore, the application of miniature flaps to repair of skin avulsion at fingers are an ideal method.Methods: From December 2006 to December 2008, the application of miniature flaps repair of skin avulsion at fingers sets of 11 cases of skin defects after guiding function in patients with early exercise, in accordance with the Chinese Medical Association of Hand Surgery Branch of finger function evaluation recycling trial comprehensive evaluation standards, on the information gathered by the use of analysis of variance test in the computer under the SAS statistical analysis software. Indicators in accordance with the application of data analysis of SAS statistical software deal reached p>0.05 considered that no significant difference, come to the application of miniature flaps to repair skin avulsion at fingers is an ideal method.Results :10 cases of miniature flaps transposition to repair the wound entirely after survived example 1 due to venous obstacle appears remote part of necrosis, by a timely change dressings and wound healing after symptomatic treatment. Postoperative follow-up of repair of finger movement and sensory function and appearance is quite satisfactory, in accordance with the Chinese Medical Association of Hand Surgery Branch finger reconstruction function evaluation trial comprehensive evaluation standards: Repair finger function gifted seven cases, good in 2 cases, the excellent rate of 81.8%, miniature flaps combined valve repair tile sets skin avulsion at fingers is an ideal surgical method, it is worth in promoting the use of clinical work.Conclusion: The double miniature flaps is an ideal option for repair of skin avulsion at fingers,which is a simple and efficient performance with minimal donor site morbidity,and it has better clinical value.Application of miniature flaps combinations repair skin avulsion at fingers is an ideal choice to complete a surgery is simple, effective and injury for the District to maximize the restoration of motor function of fingers to maximize the restoration of fingers sensory function, to maximize the restoration of the appearance of the fingers after surgery, as well as the degree of destruction of the smallest finger of health organizations, trauma recovery opponent has some clinical value. With one of dorsal metacarpal artery flap for soft tissue defects in hand, the operation is simple, retains the texture of dorsal metacarpal artery flap, and with the fingers by the District consistent color, one-time completion of finger tissue defect of the advantages of be restored; and vascular pedicle longer for the district can be directly closed, less risky surgery, scar smaller hands, with the digital artery flap watts combined antegrade repair skin avulsion at fingers is an ideal method.