Microsurgical replantation of retrograde avulsion injury of finger skin

Abstract

Objective To explore the clinical efficacy of microsurgical replantation of retrograde avulsion of finger skin. Methods From June 2013 to June 2018, 12 cases of retrograde avulsion injury of fingers were treated by the repair of fracture dislocation, skin replantation and repair of blood vessels, nerves and tendons. After operation, anti-inflammatory, anticoagulant and antispasmodic treatment were performed. They were absolutely in bed and kept warm. The blood supply, sensation and functional recovery of replanted skin were observed. Results The skin of fingers survived well in 10 cases, and a small amount of skin necrosis and scab formed in 2 cases. The wound healed well after active dressing change and scab removal. The follow-up time ranged from 6 to 12 months. 12 patients had good hand shape, soft skin, sufficient blood supply and good finger function. The total activity of flexion and extension of interphalangeal joint and metacarpophalangeal joint of the affected side were compared with those of the healthy side. According to the evaluation standard of hand function, the results were rated as excellent in 7 cases, good in 2 cases and fair 3 cases. The skin sensation recovered to S4 in 5 cases, S3 in 4 cases, S2 in 2 cases and S1 in 1 case. Conclusion The microsurgical replantation of retrograde avulsion of finger skin can reduce the necrosis rate of avulsion skin and retain the shape and function of finger to the maximum extent, which is a method worthy of reference. Key words: Finger injuries; Microsurgery; Retrograde avulsion injury; Replantation