摘要目的 通过分析并指各节段皮肤的紧张度以探讨常见并指分离不植皮技术的适应证.方法 采用并连皮肤紧张度分段评估法分析38例未植皮并指病例术前的皮肤紧张度以及与有无并发症的相关性,得出常见不植皮并指分离技术的适应证,并应用于10例完全性并指畸形的手术,以验证该适应证的临床可行性.结果 38例回顾性分析病例,有2例出现末节皮肤部分坏死导致甲上皮歪斜,1例发生甲侧襞凹陷,这3例按并连皮肤紧张度分段评估法判断,其末节均不适合不植皮的设计.10例前瞻性应用病例,根据评估结果采取合适的设计,术后手指形态及功能均正常.结论 术前采用并连皮肤紧张度的分段评估法可以预判不植皮的并指分离技术的适应证并指导手术设计.

abstractsObjective To explore the indications of simple syndactyly release without skin graft by analyzing the tension of skin in each segment.Methods In 38 cases of syndactyly release without skin flap,the tension of the fused skin was assessed segmentally.The relationship between the skin tension and the postoperative complications was analyzed to deduct the indications of simple syndactyly release without skin graft.These indication criteria were then applied to 10 finger webs in congenital syndactyly to verify the feasibility of these indications.Results Retrospective analysis of 38 cases showed skin necrosis at the distal phalange in 2 cases that resulted in nail deformities,and sunken lateral nail fold in 1 case.The above 3 cases were proven to be unsuitable for syndactyly release without skin graft according to our skin tension criteria.The 10 prospective cases which were performed with or without skin grafting based on the skin tension criteria all had satisfactory function and appearance.Conclusion Preoperative evaluation of the tension of the fused skin segmentally could predict the indication of skin graft in syndactyly release and guide the surgical design.