Application of anti skin grafting and two pedicled abdominal flap to repair the whole hand degloving injury

Abstract

Objective To explore the application of anti skin grafting and two pedicled abdominal flap to repair the whole hand degloving injury.Methods From June,2007 to December,2013,20 cases of hand degloving injury of skin and skin graft,waste application and combined application of VSD vacuum suction and two fingers abdominal pedicled skin flap repair,postoperative fingers activity,strength,degree of sensory recovery and function of four standards,respectively.After doing comprehensive evaluation.Evaluation standard:excellent for 13-16,good for 9-12 minutes,could be 5-8,difference of 4 points.Results Excellent functional recovery in 19 cases,accounting for 95％.In 1 patient the pain was not combined with exercise induced proximal interphalangeal joint part stiffness function can,accounted for 5％.Metacarpophalangeal joint activity of about 80 °-90 °,proximal interphalangeal joint activity of about 85 °-90 °.The 6 cases of sensory recovery grade S5,14 cases of abdominal two-way two subdermal vascular network flap for repair of sensory recovery S3.The patients were followed up for 2-6 years,results of 19 cases of activity were 4 points,1 case of active degree was 3,16 cases of power:4 points,3 points in 3 cases,1 case of 2 points.Feel:18 cases was 3,2 cases of 2 points.Function:18 cases was 4,2 cases of 3 points.Conclusion The operation method of small trauma,no multiple finger operation,avoids the contracture of the first web space and joint stiffness,for basic level hospital. Key words: Hand; Degloving injury ; Vacuum sealing pressure drainage technique ; Skin graft ; Microsurgical operation