带蒂股前外侧皮瓣修复手部大面积皮肤缺损  

APPLICATION OF PEDICLED ANTEROLATERAL THIGH FLAP TRANSFERRING FOR COVERAGE OF OVERSIZED SKIN DEFECT OF HAND

作　　者：张志新[1] 庄玉君 陈雷[1] 郭雅娣[1] 廉娜 

机构地区：[1]吉林大学第一医院手外科,长春130021 [2]长春烧伤医院 [3]长春整形外科医院

出　　处：《中国修复重建外科杂志》2006年第12期1199-1201,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 探讨带蒂股前外侧皮瓣在手部皮肤大面积缺损修复中的适应证。方法 2002年4月～2005年8月应用带蒂股前外侧皮瓣移位修复于部皮肤缺损，或用于修复腹部皮瓣或髂腹股沟皮瓣移位至手部后遗留的供区创面5例，均为男性，年龄16～44岁，损伤部位：左手1例，右手4例，其中机器绞伤2例、烧伤3例、外伤为伤后6h急诊手术；烧伤为伤后4～7d行切痂、皮瓣移位修复术。手部皮肤缺损范围为12～19cm×18～22cm，切取带蒂股前外侧皮瓣为7～12cm×16～24cm；切取腹部皮瓣或髂腹沟皮瓣：13～20cm×19～23cm。修复手部的皮瓣术后3周断蒂。结果 术后所有皮瓣均全部成活，未发生血管危象，创面Ⅰ期愈合。均获随访6～12个月，皮瓣质地柔软，血运好，其中3例分别在术后4～7个月行分指去脂术。手部皮瓣均恢复保护性感觉，能满足日常生活需要。结论 带蒂股前外侧皮瓣修复手部皮肤缺损及腹部皮瓣或髂腹股沟皮瓣修复手部创而遗留的供区创而具有供皮量大，不吻合血管，手术风险小，皮瓣成活率高等优点，为修复手部创面提供一种较好的皮瓣选择。Objective To introduce the applieation of the pedieled anterolateral thigh flap transferring for coverage of the oversized skin defect of the hand. Methods The pedicled anterolateral thigh flap was transferred to cover the large skin defects of the hands or the skin defects of the abdomen after the abdominal flap transferred to the hand in 5 male patients aged 16-44 years from April 2002 to August 2005. The injured sites were as follows：4 righ, hands and 1 left hand, including 2 hands injured hy a machine and 3 bands injured by hurning. The mechanically injured patients underwent an operation within 6 hours after the injury. The hurned patients were reconstrocted hy the flap transferring 4 7 days after the burn when the decayed tissues could be clearly indentified. The areas of the hand defects were 12 19 cm×18 22 cm. The areas of the pedicled anterolateral thigh flaps were 7-12 cm×16-24 cm. The areas of the abdominal flaps were 13-20 cm×19 23 era. The pedicles were separated 3 weeks after the repairing operation. Results All the flaps survived well and there was no vascular crisis, with the wound healing of the first intention. The skin defects of the hand were covered completely. Five patients were followed up for 6-12 months. The texture of the flaps was soft and the flaps had a good blood circulation. Of the patients, 3 underwent the finger exclusion and degreasing operation 4-7 months after operation. All the flaps of the hands had protective sensation, which could meet the requirement of the daily life. Conclusion The pedicled anterolateral thigh flap can provide the large coverage for the skin defects of the hands. The risk of the operation can be greatly decreased by obviation of the vessel anastomosis. It can be an optimal choice for the management of the oversized skin defects of the hands.

关 键 词：手 皮肤缺损 股前外侧皮瓣 带蒂移化 

分 类 号：R658.2[医药卫生—外科学]