切换至 "中华医学电子期刊资源库"

中华损伤与修复杂志(电子版) ›› 2025, Vol. 20 ›› Issue (05) : 421 -425. doi: 10.3877/cma.j.issn.1673-9450.2025.05.009

综述

指端软组织缺损治疗的研究进展
谢腾1,2, 唐林峰1,2,(), 巨积辉1,2   
  1. 1 215104 苏州瑞华骨科医院手外科
    2 215123 苏州大学苏州医学院
  • 收稿日期:2025-06-13 出版日期:2025-10-01
  • 通信作者: 唐林峰
  • 基金资助:
    苏州市吴中区科技计划项目(WZYW2022015)

Research advances in the treatment of fingertip soft tissue defects

Teng Xie1,2, Linfeng Tang1,2,(), Jihui Ju1,2   

  1. 1 Department of Hand Surgery,Suzhou Ruihua Orthopedic Hospital,Suzhou 215104,China
    2 Suzhou Medical College of Soochow University,Suzhou 215123,China
  • Received:2025-06-13 Published:2025-10-01
  • Corresponding author: Linfeng Tang
引用本文:

谢腾, 唐林峰, 巨积辉. 指端软组织缺损治疗的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(05): 421-425.

Teng Xie, Linfeng Tang, Jihui Ju. Research advances in the treatment of fingertip soft tissue defects[J/OL]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2025, 20(05): 421-425.

指端软组织缺损的治疗是当前临床研究热点,理想的修复方式需同时兼顾手指的感觉、功能及外观。目前,国内外针对指端软组织缺损的修复方式主要包括人工真皮及生物半透膜密闭包扎、足部游离皮瓣移植、带蒂穿支皮瓣和游离穿支皮瓣移植、指动脉岛状皮瓣移植及推进皮瓣移植等,各类术式均有其特点与适用场景。通过围绕上述修复方式的特点、应用前景及研究进展进行综述,可为临床医生制定个体化治疗方案提供参考依据。

The treatment of fingertip soft tissue defects remains a prominent focus in contemporary clinical research,with ideal repair modalities necessitating the integration of sensory function,operational capacity,and aesthetic restoration. Current therapeutic strategies for fingertip soft tissue defects domestically and internationally encompass artificial dermis with biosemipermeable membrane occlusive dressing,foot free flaps including the second toe tibial free flap,pedicled perforator flaps,free perforator flaps,digital artery island flaps,advancement flaps,and others,each characterized by distinct advantages and specific clinical indications. This article reviews the characteristics,application prospects,and research progress of the aforementioned repair methods,aiming to provide a reference basis for clinicians in developing individualized treatment plans.

[1]
Xuefeng ZJian GJiayue D,et al. Clinical effect of thumb finger reconstruction using dorsal foot flap transplant for treating thumb defects[J]. Med Hypotheses2020134:109435.
[2]
Dionyssiou DPagkalos APapas A,et al. Evolution and refinements of a dorsal adipofascial digital artery perforator flap[J]. Injury202051(Suppl 4): S48-S53.
[3]
Allen MJ. Conservative management of finger tip injuries in adults[J]. Hand198012(3):257-265.
[4]
Kashimura TNagasaki KHorigome M,et al. Selection of artificial dermis for shortening treatment period: integra versus pelnac[J]. Plast Reconstr Surg Glob Open20219(6):e3599.
[5]
Lv ZWang YChen J,et al. Pelnac® artificial dermis assisted by vacuum sealing drainage for treatment of severe avulsion injuries of the fingers[J]. J Orthop Surg Res202520(1):136.
[6]
Wang JHuang ZCueva JC,et al. Long-term follow-up of one-stage artificial dermis reconstruction surgery for fingertip defects with exposed phalanx[J]. Hand Surg Rehabil202241(3):353-361.
[7]
Zou SWang KChen Z. Application of artificial dermis combined with a medial flap from the second toe to repair degloving injury of the fingertip[J]. J Hand Surg Am202449(4):385. e1-385. e5.
[8]
Dimitrova-Chakarova PPrommersberger KJvan Schoonhoven J,et al. Outcomes of fingertip injury treatment with semi-occlusive dressings combined with surgical management within an expanded indication[J]. Handchir Mikrochir Plast Chir202557(1):32-43.
[9]
Kang D. Advancing fingertip regeneration: outcomes from a new conservative treatment protocol[J]. J Clin Med202413(13):3646.
[10]
周福成,周世义,何智阔,等. 足趾侧方Flow-through皮瓣修复伴指端血运障碍的手指软组织缺损[J]. 中华手外科杂志202440(1):29-31.
[11]
Buncke HJRose EH. Free toe-to-fingertip neurovascular flaps[J]. Plast Reconstr Surg197963(5):607-612.
[12]
del Piñal FGarcía-Bernal FJRegalado J,et al. The tibial second toe vascularized neurocutaneous free flap for major digital nerve defects[J]. J Hand Surg Am200732(2):209-217.
[13]
Li JWu HZhang Y,et al. The modified second toe flap technique based on the dorsal digital artery of the toe in finger pulp reconstruction[J]. Microsurgery202343(6):580-587.
[14]
段永明,巨积辉,张广亮,等. 游离第二足趾胫侧一蒂双瓣修复两指指端缺损[J]. 中华手外科杂志202036(1):38-40.
[15]
吕文涛,巨积辉,徐磊,等. 游离携带不同神经的双侧第二趾侧方皮瓣修复同手二指缺损的疗效分析[J]. 中国美容整形外科杂志202334(7):388-390,395.
[16]
董书男,刘承伟,江吉勇,等. 趾腓侧分叶穿支皮瓣拆分移植修复多发指端缺损[J]. 中华显微外科杂志202447(1):44-47.
[17]
贾钟喻,梁高峰,张伟,等. 趾C形Flow-through皮瓣在皮肤缺损断指再植中的应用[J]. 中华手外科杂志202440(5):406-409.
[18]
Chen ZLi MHuang S,et al. The role of great toe terminal branch artery split-thickness nail bed flaps in fingertip reconstruction surgery[J]. J Plast Reconstr Aesthet Surg202384:642-649.
[19]
Troisi LStucchi SVizcay M,et al. To do or not to do? Neurorrhaphy in great toe pulp flap fingertip reconstruction[J]. Plast Reconstr Surg Glob Open202210(9):e4539.
[20]
柯于海,李征,周望高,等. 前臂近端尺动脉穿支皮瓣修复手指指背软组织缺损[J]. 中华显微外科杂志202043(6):592-594.
[21]
Du YCui ZPu S,et al. Repair of a finger pulp or fingertip defect using a palmar rotatory flap pedicled with the perforating branch of the proper palmar digital artery: a retrospective study[J]. J Orthop Surg Res202318(1):682.
[22]
王辉,杨晓溪,王斌,等. 吻合静脉的带蒂指动脉背侧支岛状皮瓣修复同指指端或指腹缺损的效果[J]. 中华烧伤杂志202036(11):1065-1069.
[23]
Liu BPan DGao Z,et al. Double-pivot proper digital artery perforator flap for fingertip reconstruction[J]. J Orthop Surg Res202318(1):737.
[24]
Ayhan EÇevik KÇelik V,et al. Patient satisfaction after innervated digital artery perforator flap for fingertip injuries[J]. Acta Orthop Traumatol Turc202054(3):269-275.
[25]
董玉金,张铁慧,徐连春. 不同类型的游离桡动脉掌浅支穿支皮瓣修复指端缺损[J]. 中华显微外科杂志202043(2):136-140.
[26]
侯桥,刘玲芬,洪生虎,等. 游离指掌侧固有动脉近节穿支皮瓣修复手指指端软组织缺损[J]. 中华显微外科杂志202144(5):503-506.
[27]
Dağdelen DAksoy A. Evaluation of neurotized hypothenar free perforator flaps used for fingertip reconstruction[J]. Ann Plast Surg202084(2):e1-e6.
[28]
刘成龙,靳安民,庄宁,等. 游离皮瓣在手部组织缺损修复中的应用[J]. 实用手外科杂志200721(1):55-56.
[29]
Lan XHuang YGuo L,et al. Treatment of fingertip defect with reversed digital artery island flap through superficial vein anastomosis[J]. ANZ J Surg. 202191(9):E584-E588.
[30]
Siritattamrong WWongtrakul SPookhang S,et al. Modified oblique triangular neurovascular island flap technique to prevent the development of hooked nail deformity[J]. Tech Hand Up Extrem Surg202025(3):201-205.
[31]
黄悦,林枫,郝春雨,等. 改形设计指固有动脉岛状皮瓣修复复杂指端缺损的疗效[J]. 中华烧伤与创面修复杂志202339(10):947-952.
[32]
Hao RWang BWang H,et al. Repair of distal thumb degloving injury using combination of reverse dorsoradial flap of the thumb and middle finger proper digital arterial island flap[J]. J Orthop Surg Res202015(1):417.
[33]
Ma JDing YXu L,et al. Repair of fingertip defect with reverse digital artery island flap and repair of donor site with digital dorsal advancement flap[J]. Front Surg202310:1127356.
[34]
Xiong XXu MShuai M,et al. Comparative study of the clinical effects of reverse digital artery island flaps and antegrade homodigital neurovascular island flaps for fingertip reconstruction[J]. Ann Plast Surg202288(4):395-400.
[35]
Wang SYuan CDing W,et al. Repair of finger pulp defect and sensory reconstruction using reverse homodigital artery island flap with palmar cutaneous branches of the proper digital nerve[J]. Ann Plast Surg202390(6):559-563.
[36]
Kuwahara YHara TKurahashi T,et al. Comparing cinical and aesthetic outcomes of digital artery flap using nail bed graft for fingertip amputation with replantation[J]. Plast Reconstr Surg2024153(5):1086-1092.
[37]
侯春林,顾玉东. 皮瓣外科学[M]. 上海:上海科学技术出版社,2006:559-561.
[38]
马志强,谌晓强,刘军国,等. 带一侧指掌侧固有动脉的侧方V-Y推进皮瓣修复指端缺损27例[J]. 中华显微外科杂志202245(5):498-503.
[39]
Mohsen IMahmoud MShaheen A. Modified bilateral V-Y rotation advancement flap for coverage of fingertip amputations[J]. J Hand Surg Asian Pac Vol202227(6):1013-1020.
[40]
侯桥,富红梅,任国华,等. 单皮下蒂V-Y推进皮瓣联合蒂部植皮修复指端软组织缺损[J]. 中华显微外科杂志202245(2):171-174.
[41]
秦宏玖,马涛. 改良顺行指动脉推进皮瓣修复指端软组织缺损的临床效果[J]. 中华整形外科杂志202238(12):1340-1343.
[42]
李海,刘志远,肖顺娥,等. 同指递进式锯齿状不规则指固有血管神经蒂V-Y推进皮瓣在指端软组织缺损中的应用[J]. 中华手外科杂志202238(4):289-291.
[43]
Arik ACevik KÖzcanyüz B. Clinical outcomes of the oblique V-Y advancement pulp flap for repair of lateral fingertip injuries[J]. J Hand Surg Eur Vol202146(8):865-872.
[44]
Chakraborty SSKala PCSahu RK,et al. Fingertip amputation reconstruction with VY advancement flap: literature review and comparative analysis of atasoy and kutler flaps[J]. World J Plast Surg202110(3):8-17.
[45]
Zhu LZhou FZhang X,et al. Comparison treatment of medium-sized volar fingertips defects with modified triangular neurovascular unilateral advancement flap versus digital artery dorsal perforator flap[J]. J Orthop Surg Res202419(1):118.
[46]
庞海涛,刘伟,于铁强. 拇指指动脉背侧穿支皮瓣修复拇指指端缺损[J]. 实用骨科杂志202329(6):558-560.
[47]
Onode ETakamatsu KKazuki K,et al. Bipedicled digital artery perforator volar adiposal turned-over flap for reconstruction of transverse fingertip amputation[J]. JPRAS Open202232:111-115.
[48]
Atilgan NDuman N. Results of innervated digital artery perforator flap and direct-flow homodigital flap application in fingertip soft tissue amputations[J]. BMC Surg202424(1):308.
[1] 车可心, 熊枫, 杜伟力, 代强, 胡云刚, 王艺雯, 植林, 张慧君, 于东宁, 沈余明. 采用多种皮瓣修复下肢肌腱滑动性创面的临床效果[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(05): 391-396.
[2] 黄书润, 阮明珍, 陈蓝, 苏惠强, 刘丁井, 曾纯. 采用改良腹部带蒂皮瓣修复手部严重烧创伤创面的临床效果[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 284-289.
[3] 阳跃, 张昊飞, 崔子豪, 李振豪, 高建, 胡银, 郝岱峰, 冯光, 庹晓晔. 采用双侧阴部内动脉穿支皮瓣修复肛周皮肤软组织缺损的效果观察[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 301-305.
[4] 王小双, 阮琼芳, 金冬梅, 韩彦, 曹萍, 李炳辉, 褚志刚. 高糖环境下成纤维细胞分泌CXCL11对人脐静脉内皮细胞迁移的影响及其机制[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 339-346.
[5] 金方, 汤宋佳, 韩春茂, 王新刚, 张惟. 脂肪组织及其衍生物在皮肤修复与再生中的应用[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 352-357.
[6] 施芳婷, 佟希睿, 谢苏杰, 纪世召. 干细胞原位激活再生促进皮肤软组织损伤修复的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 358-362.
[7] 黄书润, 苏惠强, 刘江涛, 黄灿, 陈蓝, 陆丽萍. 个性化腹部带蒂薄皮瓣在修复手部复杂创面中的应用效果[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 206-211.
[8] 刘江涛, 潘锦燊, 王一勇, 林奕锋, 黄书润. 采用带蒂穿支皮瓣修复手部及足踝部深部组织外露创面的临床疗效[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 212-219.
[9] 李文池, 沈拓. 光动力治疗在创面修复中应用的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 248-253.
[10] 李梓伦, 吴伟滨. 3D打印技术辅助三开窗分支支架治疗主动脉夹层一例[J/OL]. 中华普通外科学文献(电子版), 2025, 19(04): 243-243.
[11] 华小玲, 高梦昕, 陈媛, 蔡超, 刘永达, 孙红玲. 良性输尿管狭窄修复重建术研究进展及再手术现状[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(03): 377-383.
[12] 刘琪, 张亚伟, 符洋. 肿瘤相关腹壁疾病的诊疗策略与重建技术[J/OL]. 中华疝和腹壁外科杂志(电子版), 2025, 19(04): 365-370.
[13] 宋致成, 杨董超, 董文培, 吴巨钢, 杨建军, 顾岩. 桥接技术修复复杂腹壁缺损的回顾性临床研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2025, 19(04): 412-416.
[14] 彭惊龙, 张潇月, 王红美. 脐带间充质干细胞治疗造血干细胞移植术后卵巢早衰的研究进展[J/OL]. 中华细胞与干细胞杂志(电子版), 2025, 15(04): 245-250.
[15] 唐洪, 刘俊利, 金正. 肩关节镜下肩袖撕裂修复围手术期焦虑及睡眠管理:一项前瞻性随机对照试验[J/OL]. 中华肩肘外科电子杂志, 2025, 13(03): 163-169.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?