Individual formation selection of repairing method in hand tissue defect

Objective To explore how to select quickly the individual formation of repaired methods in hand tissue defects.Methods By summary of the clinical treatment of 3559 cases in hand tissue defects of different situations,the hand tissue defects were divided into two major categories of skin-soft tissue defects and composite tissue defects,each category based on the defect area,texture,defect organization type was to be select various surgical methods.We divided into 11 kinds of defect types,18 kinds of options such asfree skin graft,abdominal pedicle flap,free flap,free miniature flap,free composite miniature flap inducting the formatial screening ideas of various efficient surgical program in accordance with the different types of defect classification.Results The group of 3559 cases in which free vascularized tissue transplantation 802 cases,787 cases successfully survived,partial necrosis of 8 cases,failure 7 cases,the survival rate was of 98.2％.Pedunculated tissue transplantation 1302 cases and successfully survived 1288,partial necrosis of 14 cases,the survival rate was of 98.9％.Full thickness skin 1455 cases,1432 cases successfully survived,partial necrosis in 23 cases,the survival rate was 98.4％.The group a total of 254 cases obtained from 6 to 36 months of follow-up,the patient had no significant bloated appearance of the hand,the flap region texture,elasticity and function were satisfactory.Sensory recovery of S2-S4,two-point discrimination 5-8 cm.According to the Chinese Medical Association Society of Hand Surgery trial upper part of the functional assessment criteria,the excellent rate was of 86.7％.Conclusion The classification of hand tissue defect and the repairing method lists,can be more effective reasonable surgical treatment options and treatment results of tissue defects Key words: Hand; Tissue defects; Repair; Clinical pathway