Method of surgical treatment of cutaneous forms of syndactyly

 

The invention relates to medicine, namely to surgery and may be applicable for surgical treatment of cutaneous forms of syndactyly. Produce sawtooth cuts to the edge of the finger. Move the triangular skin flaps toward each other, closing the defect with local tissues. The method allows to prevent marginal necrosis, the formation of flexion contractures. 2 Il.

The invention relates to medicine, namely to surgery, and can be, in particular, used for surgical treatment of cutaneous forms of syndactyly.

Of practical medicine for the treatment of cutaneous forms of syndactyly known method (Dzhanelidze Yu Yu skin grafts by means of a long tubular strips. - New. hir. archive. - 1924. - 3., S. 22), which is as follows: after the linear separation of the fingers in order to prevent wrinkling of the skin is free of her transplant. However, the disadvantage of this method is that we have to take the skin with a certain part of the body, causing additional trauma to the patient, the skin is not always well adapted to the result of necrosis.

There is also known a method of separating fingers triangular the Oia fingers form triangular flaps, then the defect of one of the fingers close with his skin of the finger, and to remedy the defect on another finger of the use of free skin grafts. A serious disadvantage of this method is also additional trauma to the patient, and the risk of skin necrosis.

The closest in technical essence and the achieved result is a method of surgical treatment of cutaneous forms of syndactyly involving the mutual exchange of multiple pairs of triangular flaps (i.e., including sawtooth sections with subsequent movement of the triangular skin flaps towards each other), and the skin defect closing local tissues (Limburg A. A. Planning of local plastic surgery on the body surface. - L.: publishing house of medical literature, 1963, S. 457-459).

However, the known method has the following disadvantages: involves the combination of a plate of local fabrics with a free skin graft, which is technically more difficult; not always providing good cosmetic and functional result from formation of flexion contractures of the fingers; may develop marginal necrosis because of the strong tension of the skin and circulatory disorders of the finger.

Technical financial p is marginal necrosis in the early postoperative period and flexion contractures of the fingers later.

The technical result is achieved in that in the method of surgical treatment of skin form syndactyly, including sawtooth cuts, then moving triangular skin flaps towards each other with the closure of the skin defect local tissues in the formation of the triangular flaps of the sections shown to the edges of the finger.

The method is as follows. First two injection needles, threaded through the fusion between the fingers represent the Foundation of the triangular flaps. Then, as shown in the diagram (Fig.1), cut out each finger two triangular flap, so that when the opposite movement was possible to close the skin defect on the adjacent finger, and the cuts are not to the middle, as in the previous methods, and to the ends of the finger, which provides greater extensibility flaps. Great pliability of skin flaps is achieved also due to the fact that the triangular flaps interdigital interval Viravaidya more proximally than it was previously accepted, and through better smesimosti skin of the back of the hand, that allows to cover a large area of the defect between the toes. Dorsal and Palmar triangular patches sew on type “swallow the e syndactyly II and III fingers of the right hand. In connection with this disease 23 March 1999 made the division II and III fingers of the right hand, followed a zigzag skin grafting, local fabrics. The operation is performed under intravenous anesthesia. On the middle third of the forearm imposed harness. Through the fusion between the fingers held 2 needles to denote bases of the triangles. Then, on each finger cut by 2 triangular flap, sections thus produced to the edges of the fingers. The fingers are separated. Isseen excess fatty tissue. The flaps on each finger moved towards each other, sewn along the edges of the defects. Interdigital period sutured type “dovetail”. Imposed aseptic bandage. Immobilization plaster Longuet. The postoperative period was uneventful. The wound healed by first intention.

One year after surgery the patient has no complaints. Marked by good cosmetic and functional effects - function brush in full, contractures and rough scars formed.

Clinical example 2. Patient K., 1978 R. (21) 22 January 1999 was admitted to the hospital with a diagnosis: syndactyly II and III fingers of the left foot. Regarding this pathology 25 January 1999 was made the division II and ogen harness. Conducted two injection needle through the seam between the fingers to denote bases of the triangles. Then, on each finger cut two triangular flap, sections thus produced to the edges of the fingers. the fingers are separated. Isseen excess fatty tissue. The flaps on each of the fingers are moved toward each other, sewn along the edges of the defects. Interdigital period sutured type “tail swallows”. Imposed aseptic bandage. Immobilization plaster Longuet. The postoperative period was uneventful. The wound healed by first intention.

One year after surgery the patient has no complaints. Marked by good cosmetic and functional effects function of the foot in full, contractures and rough scars formed.

Significant advantages of the proposed method are:

1) the Ability to lay the skin flaps without tension, closing large skin defects;

2) the Ability of dosed tension flap, which reduces the risk of marginal necrosis in the early postoperative period and the formation of flexion contractures in the following;

3) is Not expected to causing additional trauma to the patient during the taking of the skin with each special surgeon training and special tools.

Claims

Method of surgical treatment of cutaneous forms of syndactyly, including sawtooth cuts, then moving triangular skin flaps towards each other with closure of the defect with local tissues, characterized in that when forming a triangular flap sections hold up to the edge of the finger.



 

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