(足母)甲瓣切取术后供区创面覆盖的方法选择

目的探讨足母]甲瓣切取术后供区修复的方法，减少供区并发症的发生。方法对足母]甲瓣切取术后25例足母]趾创面，采用三种不同的方法处理，其中采用游离皮瓣移植修复9例，采用足背或足底局部带蒂皮瓣修复12例，采用第二足趾皮甲瓣修复4例。结果移植皮瓣全部成活，术后平均随访10个月，其中2例游离皮瓣在术后6个月进行二期削薄，外观和功能满意。第二趾皮甲瓣修复后的功能在3种方法中效果最好。结论根据足母]甲瓣供区的缺损情况，采用不同的手术方法进行即时修复，能最大限度减少供区并发症的发生。

How to cover the defect of great toe after the wrap-around flap transfer

Objective To explore the methods for coverage of the defect of great toe after the wrap-around flap transfer, and decrease the morbidity of donor site in great toes. Methods Twenty-five patients received three kinds of procedure for immediate resurfacing of donor defect of the great toes during wrap-around flap transfer. Among them, 9 cases received the free flaps for coverage of defect in donor great toes, 12 cases was repaired by local pedicled dorsal or plamarpedis flaps, and the other cases were treated by the nail-flap of second toe. Results All the flaps were survival. Two patients received the flap thinning procedure in 6 months later, all patients were satisfied with cosmetic and functional outcome. The appearance and sensory function of donor toe repaired by second toe nail-flap was best among three methods. Conclusion According the detect situation of great toes, three kinds of nap were selected for immediate coverage of donor site, which can decrease the complication of donor great toe at the most.