Objective To evaluate the effectiveness of vacuum sealing drainage (VSD) combined with skin grafting to repair donor site for wrap around flap of hallux toe. Methods: From Jan. 2009 to Apr. 2010,20 patients with injury of hallux toe were repaired by wrap around flap of hallux. There were 16 males and 4 females, with ranging in age from 18 to 45 years (averaged 36 years). The causes of injury:mechanical injury in 18 cases, road accident in 1 and postoperative hemangioma of hallux in 1. The degree of hallux defect as follow: grade Ⅰ 10 cases, grade Ⅱ6 cases,grade Ⅲ 4 cases. All patients' feet underwent 64row CT angiography pre-operation,there were exposed bone and tendon tissue,the area of hallux ranged from 5 cm×3 cm to 7 cm×5 cm,all cases underwent vacuum sealing drainage combined with dermatoplasty of full thick skin graft for repair of donor site for wrap around flap of hallux toe. Results :The raw surface of donor site in all patients survived without complications such as skin ulceration and exudation. After follow-up for 3 to 12 months, the skin appearance of raw surface was excellent with well function. Conclusion: VSD associated with dermatoplasty of full thick skin graft to repair donor site for wrap around flap of hallux toe can obtain satisfactory effect in treating injury of hallux toe,which can reduce difficulty of wound healing,improve skin appearance of donor site and relieve pain of patients.%目的:总结联合使用VSD封闭式负压引流技术、植皮术修复拇甲辩供区的临床效果与体会.方法:自2009年1月至2010年4月实施的拇甲辩手术20例,男16例,女4例;年龄18～45岁,平均36岁.致伤原因:机械伤18例,车祸1例,拇指血管瘤术后1例.缺损程度:Ⅰ度10例,Ⅱ度6例,Ⅲ度4例.术前均行64排CT足部血管成像,术中创面均存在骨及肌腱组织外露,拇趾供区范围为5 cm×3 cm～7 cm×5 cm,拇趾供区均采用VSD封闭式负压引流后应用全厚皮片植皮的方法修复.结果:20例拇趾供区创面植皮全部存活,无植皮破溃及渗出等并发症;术后随访3～12个月,足趾植皮外形满意,功能良好.结论:VSD封闭式负压引流技术联合全厚皮片植皮术修复足拇甲瓣供区创面,能降低供区创面修复难度,改善供区组织缺损修复外形,减轻换药痛苦,疗效满意.
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