[Effectiveness comparison between two kinds of procedures for treatment of totally degloved hand]

To compare the effectiveness between toe transfer combined with an abdominal flap and bag-shaped abdominal flap for treatment of totally degloved hand.

Between January 2005 and January 2012, 18 patients with totally degloved hand were treated by two kinds of techniques. Those patients were divided into 2 groups according to the technique. The bag-shaped abdominal flap was used in 8 cases (group A), and toe transfer with a dorsal is pedis skin flap combined with abdominal S-shaped tile-joint subdermal vascular network flaps was performed in 10 cases (group B). There was no significant difference in gender, age, injury cause, injury degree, and interval between injury and operation between 2 groups (P > 0.05). The static two-point discrimination (s2PD), grip power of the reconstructed hand, time of returning to work, and active total range of motion (ROM) of the operated finger were compared between 2 groups to assess the effectiveness.

All flaps and skin grafts survived in 2 groups. One flap suffered vascular crisis at 2 days after operation and survived after surgical exploration in group B. All patients were followed up 12-24 months (mean, 16 months). At last follow-up, group B showed a better recovery of s2PD of the thumb and ROM, and shorter time of returning to work than group A (P < 0.05), but no significant difference was found in grip power of the reconstructed hand and s2PD of the other fingers between 2 groups (P > 0.05).

The technique of toe transfer combined with an abdominal flap is better than traditional bag-shaped abdominal flap with the advantages of easy dissection, less time of operation, and satisfactory functional recovery.