背景:Atasoy皮瓣被认为是简单而可靠的覆盖成人远端指缺损。对儿童的各种研究显示出更多对比结果,特别是在美学和功能方面。这项研究的目的是评估这种皮瓣的长期结果,特别是在儿童,以确定其局限性和适应症。
目的:Atasoy皮瓣是可靠且可重复的,可覆盖儿童远端指状物质丢失至2区。
方法:纳入了在2017年1月至2020年1月期间接受Atasoy皮瓣手术的56名儿童。病变面积,手术技术,术后并发症(感染,治疗困难,坏死),以及最终的指甲外观,冷不耐受或手指疼痛,手指驱逐,延伸缺陷,并对最终家长满意度进行了分析。
结果:对49名儿童进行了评估,平均随访时间为18个月(min=3个月,max=38个月,SD=11.3个月)。十八个孩子有钩钉,导致其中6人的手指被排除在外。大多数钩钉在III区和近端II区病变中(12例)。89%的远端缝线固定到甲床的儿童(8名儿童)患有这种并发症。9名儿童存在冷不耐受。无延伸失败或术后早期并发症。最终家长满意度为9.1/10(min=5,max=10,SD=1.3)。
结论:儿童Atasoy皮瓣对于覆盖远端指状物质的丢失似乎是可靠的。主要并发症是钩钉的发生。符合其适应症(横向物质损失不超过II区的近端三分之一)和精确的手术技术(远端针固定而不缝合到甲床,深层襟翼提升,不关闭捐赠部位)有助于限制这种风险。
方法:IV;回顾性研究。
BACKGROUND: The Atasoy flap is considered simple and reliable for covering distal digital defects in adults. Various studies in children have shown more contrasting results, particularly in terms of aesthetics and function. The aim of this study is to evaluate the long-term results of this flap specifically in children, in order to determine its limitations and indications.
OBJECTIVE: The Atasoy flap is reliable and reproducible for coverage of distal digital substance loss up to zone 2 in children.
METHODS: Fifty-six children who benefited from an Atasoy flap operated on between January 2017 and January 2020 were included. Lesion area, operative technique, postoperative complications (infection, healing difficulties, necrosis), and ultimately nail appearance, cold intolerance or finger pain, finger eviction, extension defect, and final parental satisfaction were analyzed.
RESULTS: Forty-nine children were evaluated with a mean follow-up of 18 months (min = 3 months, max = 38 months, SD = 11.3 months). Eighteen children had a hook nail, resulting in 6 of them having their finger excluded. The majority of hook nails were found in zone III and in proximal zone II lesions (12 cases). Eighty-nine percent of children with distal suture fixation to the nail bed (8 children) had this complication. Cold intolerance was present in 9 children. There were no cases of extension failure or early post-operative complications. Final parent satisfaction was 9.1/10 (min = 5, max = 10, SD = 1.3).
CONCLUSIONS: The Atasoy flap in children appears reliable for covering loss of distal digital substance. The main complication is the occurrence of hook nails. Compliance with its indications (transverse substance loss not exceeding the proximal third of zone II) and a precise surgical technique (distal needle fixation without suturing to the nail bed, deep flap lift, non-closure of the donor site) help limit this risk.
METHODS: IV; retrospective study.