수부의 도서형 피판술

초록

Soft tissue defects of the hand overlying joints, tendons, neuro-vascular pedicle, and tactile surfaces require full thickness skin and subcutaneous tissue. The island flaps were performed successfully to reconstruct the soft tissue defects of the hands. We obtained following results. 1. From Jul. 1984 to Dec. 1992, we performed island flaps in 67 cases(neuro-vascular island flap in 21 cased, arterialized island flap in 5 cases, reverse island flap in 39 cases, neuro-vacular volar advancement flap in 2 cases), among which 41 cases were followed up for more than 36 months. 2. The survival of the flap was successful in all cases except on case of total necrosis in reverse island flap. The transfered flaps were good in durability and cosmesis. 3. Recovery of the protective sensation such as pain & touch were good. In 7.5% of the patient who received these procedures, 2 point discrimination distance was less than 15mm. 4. Only 3 of the 13 patients who received neuro-vascular island flap with follow-up ranging from 3 to 30 months acheived cortical reorientation. 5. The island flap procedure for the coverage of the soft tissue defect of the hand was a time-saving, one-stage operation. It was possible to transfer good quality skin together with its subcutaneous fibrous fatty padding. The patients who received these procedures had no uncomfortable immobilization of the hand.

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