Clinical effect of abdominal pedicled skin flap repair on hand trauma and infection patients with bone exposure

OBJECTIVE To explore the clinical effect of abdominal pedicled skin flap repair on the hand trauma and infection patients with bone exposure. METHODS A total of 84 hand trauma and infection patients with bone exposure who were treated in Hangzhou Plastic Hospital from Jan 2018 to Jan 2022 were recruited as the research subjects and were randomly divided into the control group with 42 cases and the stud group with 42 cases. The control group was treated with free skin flap repair, and the study group was given abdominal pedicled skin flap repair. A 6-month follow-up was conducted after the surgeries. The effective rate of treatment, satisfaction with treatment, operation duration, wound healing time, time of use of antibiotics for treatment of infection and normal ratio of skin flap color were observed and compared between the two groups after the surgeries for 6 months; the recovery of hand function was observed after the surgeries, the inflammatory factors were observed before and after the surgeries for 6 months, and the complications during the follow-up were analyzed. RESULTS There was no significant difference in the total effective rate between the study group and the control group after the surgeries for 6 months. The scores of overall function, working ability, daily living ability, appearance and satisfaction with hand of the study group were higher than those of the control group; the pain score of the study group was lower than that of the control group(P<0.05). The operation duration, wound healing time and time of use of antibiotics for treatment of postoperative infection were shorter in the study group than in the control group(P<0.05). The levels of serum interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), lipase (LPS) and C-reactive protein (CRP) of the two groups were reduced after the surgeries for 6 months, and the levels of above indexes of the study group were lower than those of the control group(P<0.05). There was no significant difference in the total satisfaction between the study group and the control group after surgeries for 6 months. The incidence of complications was 4.76% during the follow-up, lower than 21.43% of the control group(P<0.05). CONCLUSION The abdominal pedicled skin flap repair can shorten the operation duration and wound healing time, effectively prevent the postoperative infection in the hand trauma and infection patients with bone exposure, alleviate inflammatory reactions, and promote the recovery of hand function; it has favorable efficacy and safety.