Dermatological and finger separation
Dermatological and finger separation is used for surgical treatment of congenital and malformation. Congenital and malformation is one of the most common congenital hand deformities. Men are three times more likely than women to have a variety of deformities, especially in the middle and the ring. The degree and quantity of the fingers are not the same. The light ones only refer to the slightly longer or two fingers of the skin. The two fingers or multiple fingers are not only closely connected to the skin, but also the nails, phalanges and metacarpals are connected together. Finger blood vessels, nerves and tendons.
And refers to the deformity is divided into two categories, that is, soft tissue refers to the bone and refers to. The purpose of corrective surgery is to reconstruct the shape of the fingernail and to avoid flexion and contracture of the finger.
It is generally believed that the age of the sick child at the time of surgery should be determined according to the severity of the joint. Light and refers to the slightly longer and incompleteness of the sputum, and the surgical separation should be postponed until after 5 years of age to prevent the scars formed by the fingers and the surgery from growing synchronously and affecting the development of the hand. However, for severe and deformed, it is suitable for early surgery because it restricts the movement of the hand and hinders the growth and development of the hand. The sick child is performed after 1 year and a half and refers to the separation surgery, which is expected to obtain satisfactory results. However, the complicated deformity of multiple fingers connected together, whether it is simple skin and refers to the skin or phalanges, should be staged or multiple operations, avoid separating multiple fingers at once and even deformed, avoiding Finger necrosis caused by blood circulation disorder.Treating diseases: and referring to deformities Indication
1. X-ray film confirmed by simple skin and refers to deformity.
2. If the sick child is complete and refers to deformity, and the joints of the fingers and joints are not in the same plane, it will affect the growth and development of the fingers, so surgery should be performed at the age of one and a half.
3. If it is partial and refers to deformity, or just refers to the shallower, the surgery should be postponed until the age of 5 years.Surgical procedure
First, a rectangular flap and two triangular flaps are designed on the back side of the finger. The rectangular flap is located at the proximal end of the finger and its base is at the same level as the normal finger, and the length is approximately 2/3 of the proximal finger and is of sufficient width to allow the flap to cover the finger. Two triangular flaps are designed at the distal end of the rectangular flap, the base of which is connected to the skin of the dorsal side of the two fingers, respectively, but the side of the middle finger is as far as possible, so that the ulnar side of the middle finger will be completely covered by the flap. A rectangular flap and two triangular flaps are then designed on the side of the palm. The base of the rectangle is connected to the skin of the palm of the middle finger and perpendicular to the middle finger. It will cover the proximal side of the middle finger and part of the back side of the wound, and then design two triangular flaps at the distal end of the rectangular flap.
2. Cut and form a flap
Cut the skin and subcutaneous fat tissue along the incision line, and form rectangular and triangular flaps on the volar and dorsal sides respectively. Be careful not to damage the finger nerves and blood vessels, and try to retain the subcutaneous fat tissue, especially in the separation of the fingertips.
3. suture flap and free skin graft
Firstly, the rectangular flap of the proximal side of the dorsal side is covered with the fingertip and sutured to the proximal edge of the volar side, and then the lateral flap of the proximal side of the volar is covered with the lateral edge of the proximal side of the middle finger, and sutured to the back side of the proximal part of the middle finger. On the edge. Then, the triangular flap on the dorsal side of the palm is trimmed so that the flap covers the middle finger wound and sutures the flap intermittently. The skin defect of the ring finger can be cut into full-thickness skin slices, and the free skin graft can cover the wound surface.complication
1. Flap and free skin graft necrosis
This is due to the fact that the base of the flap is too narrow and the compression dressing of the skin graft area is not correct. Once it happens, it should be changed in time to prevent infection.
2. Wound infection
In addition to paying attention to aseptic procedures, it should be noted that antibiotics should be given after surgery and the drug should be changed in time. If a serious infection occurs, the flap and free skin may be necrotic, resulting in wound healing or scar formation, and the separated fingers may be connected.