이차적 치료방법으로 실시한 신경혈관경 피부편수술에 대한 임상적 고찰

Abstract

The transfer of a sensory island of skin to an anesthetic area on the hand has been the most important development in hand surgery in the past decade. A neurovascular island flap transfer has proved useful for the treatment of finger injuries in primary cases and in secondary cases. The purpose of this paper is to describe the use of local composite tissue, isolated and transferred on a neurovascular pedicle graft for the secondary recon- struction procedures of finger injuries. Thirty two fingers had been operated on for "neurovascular island flap" coverage operation at the Department of Orthopedic Surgery, Yonsei University, Severance Hospital and Inchon Severance Hospital during the period from 1983 to 1992. The follow up study was carried out on twenty hands over a year period after an operation. The results obtained were as follows. 1. Among twenty hands the cases of thumb are ten. The index are eight, other fingers are two. 2. The ratio between male and female was about 4: 1 The most common procedures of primary treatment were abdominal distant flap (14cases). 3. All had better touch, pain and temperature sensibility in the flap than the surrounding recipient area. Thirteen patients reffered a pinprick in the flap to the donor finger, All had decreased two point discrimination corresponding to the pulp about 6 months after operation. 4. The use of neurovascular pedicle graft as a method of tissue transfer which permits a wide range of motion and comfortable appearance without jeopardizing either circulation or sensation.