指背动脉为蒂的筋膜瓣修复指皮肤缺损的临床研究

Clinical Study of Fascial Flap Pedicled with Dorsal Digital Artery in Repair of Finger Skin Defect

摘要: 目的：研究指背动脉为蒂的筋膜瓣修复指皮肤缺损的临床疗效。方法：选取2020-07-01~2022-02-01就诊于福建中医药大学附属第二人民医院东二环院区外科手指皮肤缺损的患者共100例，随机分为两组，实验组采用指背侧筋膜瓣修复手指皮肤缺损50例，对照组指固有动脉岛状皮瓣50例，修复单指中、末节掌侧、背侧及指端缺损，术后随访3个月，填写指部缺损修复患者评价量表，对皮瓣感觉(包含两点辨别觉、之间痛觉)、关节活动、血液循环及总分进行比较。结果：50例指背侧筋膜瓣修复手指皮肤缺损全部存活，两组皮瓣感觉差异具有统计学意义(T = 5.974, p = 0 < 0.05)，两组皮瓣的两点辨别觉差异具有统计学意义(T = 5.015, p = 0 < 0.05)，两组皮瓣的之间痛觉比较具有统计学意义(T = 5.958, p = 0 < 0.05)，两组关节活动无统计学意义(T = 0.172, p = 0.864 > 0.05)，两组血液循环有统计学意义(T = 6.093, p = 0 < 0.05)，总分明显高于对照组，两组差异具有统计学意义(t = 20.556, p < 0.05)。结论：指背动脉为蒂的筋膜瓣修复指皮肤缺损操作简便，具有存活率高、感觉恢复、关节活动好等特点，是修复指皮肤缺损的良好治疗方法。

Abstract: Objective: To study the clinical effect of fascial flap pedicled with dorsal digital artery in the repair of finger skin defect. Methods: A total of 100 patients with finger skin defects who were treated in the East Second Ring District of the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from 2020-07-01~2022-02-01 were selected. The patients were randomly divided into two groups. The experimental group of 50 cases used the dorsal fascia flap to repair the skin defect of the finger, and the control group of 50 cases used the proper artery island flap of the finger to repair the defect of the middle, distal volar, dorsal and finger end of a single finger. The patients were followed up for 3 months after operation, and the patient evaluation scale for the repair of finger defect was filled in, and the flap sensation (including two-point discrimination and pain sensation between two points), joint motion, blood circulation and total score were compared. Results: All 50 cases of finger skin defect repaired with dorsal finger fascia flap survived. There was a statistically significant difference in skin flap sensation between the two groups (T = 5.974, p = 0 < 0.05). The difference in two-point discrimination between the two groups of flaps was statistically significant (T = 5.015, p = 0 < 0.05), and the pain sensation between the two groups of flaps was statistically significant (T = 5.958, p = 0 < 0.05), there was no statistical significance in the joint activities between the two groups (T = 0.172, p = 0.864 > 0.05), the blood circulation in the two groups was statistically significant (T = 6.093, p = 0 < 0.05), and the total score was significantly higher than that in the control group. The difference between groups was statistically significant (t = 20.556, p < 0.05). Conclusion: The fascial flap pedicled with the dorsal digital artery is easy to operate, has the characteristics of high survival rate, sensory recovery, and good joint movement. It is a good method for repairing the skin defect of the finger.