Nail bed defect reconstruction using a thenar fascial flap and subsequent nail bed grafting

Lee, Kyung Jin; Kim, Yong Woo; Kim, Jin Soo; Roh, Si Young; Lee, Dong Chul

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자료유형: 학술저널

저자정보: Lee, Kyung Jin (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) Kim, Yong Woo (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) Kim, Jin Soo (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) Roh, Si Young (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) Lee, Dong Chul (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital)

저널정보: 대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제46권 제1호

발행연도: 2019.1

수록면: 57 - 62 (6page)

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연구주제

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연구방법

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연구결과

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Background Full-thickness nail bed defects with significant exposure of the distal phalanx are typically challenging to reconstruct. We describe a novel method of nail bed defect reconstruction using a thenar fascial flap combined with nail bed grafting. Methods Full-thickness nail bed defects were reconstructed in a 2-stage operation involving the placement of a thenar fascial flap and subsequent nail bed grafting. A proximally-based skin flap was designed on the thenar eminence. The flap was elevated distally to proximally, and the fascial layer covering the thenar muscle was dissected proximally to distally. The skin flap was then closed and the dissected fascial flap was turned over (proximal to distal) and inset onto the defect. The finger was immobilized for 2 weeks, and the flap was dressed with wet and ointment dressings. After 2 weeks, the flap was divided and covered with a split-thickness nail bed graft from the great toe. Subsequent nail growth was evaluated on follow-up. Results Nine patients (9 fingers) treated with the novel procedure were evaluated at follow-up examinations. Complete flap survival was noted in all cases, and all nail bed grafts took successfully. Five outcomes (55.6%) were graded as excellent, three (33.3%) as very good, and one (11.1%) as fair. No donor site morbidities of the thenar area or great toe were observed. Conclusions When used in combination with a nail bed graft, the thenar fascial flap provides an excellent means of nail bed reconstruction.

#Finger injuries #Nails #Fascia #Reconstructive surgical procedures #Surgical flaps

참고문헌 (18)

참고문헌 신청

Dellon AL / 1983 / The proximal inset thenar flap for fingertip reconstruction / Plast Reconstr Surg 72:698~704

Flatt AE / 1957 / The thenar flap / J Bone Joint Surg Br 39-B:80~85

Sommer NZ / 2016 / Green’s operative hand surgery / Elsevier :318~337

Zook EG / 1984 / A study of nail bed injuries : causes, treatment, and prognosis / J Hand Surg Am 9:247~252

Clayburgh RH / 1983 / Nail bed repair and reconstruction by reverse dermal grafts / J Hand Surg Am 8(5 Pt 1):594~598

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