北京大学学报（医学版）2012，Vol.44Issue(6)：860-865,6.DOI:10.3969/j.issn.1671-167X.2012.06.011
游离全厚皮肤移植重建甲床完全缺损的临床研究
Clinical study of full-thickness skin graft for reconstruction of completely defect nail unit
李文军 1李淳 1朱瑾 1田光磊 1陈山林 1田文1
作者信息
摘要
Abstract
Objective: To explore a reconstruction method for complete nail bed defect caused by various kinds of reasons and to retrospectively analyze the effect of application of free full -thickness skin graft for the whole nail unit repair. Methods; Between Apr. 2010 and Mar. 2012, the method of free full-thickness skin graft was done for reconstruction of the completely nail unit defect in seven cases. There were 2 male and 5 female patients; the mean age of these patients at the time of surgery was 51.9 years ( range : 7 to 70 years) . The pre-operative diagnoses included two cases of malignant melanoma, one of chronic infection, one of squamous cell carcinoma, two of subungual pigmentation and one of junc-tional nevus. There were 2 thumb lesions, 3 middle and 2 index finger lesions. Nail unit defect was in the range of 1. 5 cm X 2 cm to 2. 5 cm x 3. 5 cm and full thickness skin graft was harvested from the same medial side of upper arm (3 cases) , forearm cubital fossa (1 case) and contralateral side of groin region (3 cases). Results; All the patients were followed with an average follow-up time being 10 months. All the free skin graft taken was achieved with 100% in all the 7 cases, even in those patients whose partial cortical bone had been curetted. The skin graft was often bluish initially, and superficial blisters were always noticed within 1. 5 months postoperatively and the survival skin graft was smooth eventually, and skin graft was adhered to the underlying bone tightly. There was no epidermal inclusion cyst and no residual nail formation. The skin donor sites were without complications. Aesthetic appearance was assessed by the surgeons and found no unacceptable for their patients. And all the patients were satisfied with the cosmetic appearance and active range of motion of their involved fingers, who did not express a desire to undergo any further of nail reconstruction. Conclusion; Free full-thickness skin grafting for reconstruction of the complete nail unit defect is a simple, safe and effective procedure which provides a satisfactory aesthetic appearance and does not make any significant skin donor site morbidity especially for middle-aged and elder patients.关键词
皮肤移植/修复外科手术/指甲疾病Key words
Skin transplantation/ Reconstructive surgical procedures/ Nail diseases分类
医药卫生引用本文复制引用
李文军,李淳,朱瑾,田光磊,陈山林,田文..游离全厚皮肤移植重建甲床完全缺损的临床研究[J].北京大学学报（医学版）,2012,44(6):860-865,6.
