Emergency microsurgery repair and one stage functional restoration in treatment of severe tissue defect of the hand / 中国矫形外科杂志

ABSTRACT

[Objective] To approach the methods of emergency microsurgery repair and one stage functional restoration in tretment of severe tissue defect of the hand.[Method]Fifteen cases of large skin compounded defects of thumb,'hukou',back of hand and palm were repaired with second toes along with anterior malleolus flap,and extend flap of dorsum of foot.Two hundreds and fifty-two cases of compounded defects of 'hukou',back of hand palm and forearm were repaired with second toes or big nail skin flap along with flap transplantation and thumb reconstruction.Thoracoumbilical flap was used in other 372 cases with bone and muscle defect or the big skin defect of the forearm.The lateral thoracic flap and scapular flap was used in repair of 18 cases of the avulsion of the hand.The lateal thoracic flap covered the raw surface of the back hand,the scapular flap covered the raw surface of the palm,so as to completely wrap up the hand or the hand complic forearm.[Result]Seven cases were found vessel crisis in the free skin flap and tissue flap,they all survived after surgical exploration and reanastomosis of blood vessel.One stage healing was gained in 619 cases,two stage healing was gained in 38 cases.All cases were followed up for 1~15 years.According to the criteria of upper limb of C.M.A hand surgery institute,there were excerllent in 340 cases,good in 228 cases,fair in 65 cases,bad in 24 cases,with the satisfactory rate of 86.5%.[Conclusion]It is an effective method of emergency microsurgery repair and one stage functional restoration in tretment of severe tissue defect of the hand.