The Clinical Application Of Pedicle Improved Suture In Fingertip Skin Defect Repaired By Retrograde Is Land Flap

Objective: To explore the new strategy of suturing the retrograde island flap in the hand,and to reduce the swelling and necrosis of the flap caused by the pedicle pressure.Methods: The clinical data of 40 patients with skin defects were retrospectively analyzed retrospectively from August 2015 to July 2016 in the First Affiliated Hospital of Shihezi University Medical College.The patients were divided into two groups: Modified group of 20 patients.Including 22 men,18 females,aged 21-65 years,mean age 34 years old.6 cases of thumb finger injury,2 cases of index finger injury,18 cases of middle finger injury,12 cases of ring finger injury,2 cases of finger finger injury.40 cases were finger-end skin defects,accompanied by finger bone tendon exposed or nail bed defects.Defect area 1.0cmx1.5cm to 2cm-2.5cm.Six cases of retrograde first metacarpal(radial)ulnar dorsal flap,6 cases using retrograde side of the vascular chain flap,28 cases using retrograde finger flap to repair the wound.In the traditional group,20 cases were treated with in situ suture method,and 20 cases of modified group were treated with dislocation stitch method to close the skin of the pedicle.According to the traditional group and the improved group were compared with the patient's skin flap swelling degree and survival status;follow-up 6-11 months,using two-point discrimination to assess the skin feel finger finger,using the American Hand Surgery Society recommended TAM(Total active movement(TAM)system assessment method to assess finger finger functionResults: The flap of the flap was not obvious in the modified group,and no recurrence of venous return occurred.Twenty cases of flap were healed without skin flap necrosis.6-9mm,hand TAM score excellent.The flap of the flap was different in the traditional group,and the flap was necrotic in 4 cases due to severe swelling.After 6 to 11 months follow-up,the flap was 7-10 mm.Hand TAM score fine.Conclusion: 1.In the case of retrograde island flap pedicled with retrograde island flap,the skin of the "tunnel area" was cut and stitched,and the length of the finger skin was transformed into " Tunnel area " the width of the skin,an increase of " tunnel area " area,the bottom of the vascular pedicle does not form a pressure,to avoid the flap after swelling and necrosis.2.hand retrograde island flap pedal improved suture method and the traditional suture method,can restore the excellent hand function and better fingertips feel.