跨中线肩胛游离皮瓣修复手足大面积软组织缺损  

Repair of massive soft tissue defect in upper and lower extremities with free transmidline bi-lobed scapular skin flap

作　　者：王强[1] 赵玉玲[1] 曹全斌[1] 胡福兴[1] 朱典勇[1] 

机构地区：[1]解放军第八十九医院烧伤整形科,山东潍坊261021

出　　处：《中华烧伤杂志》2006年第6期437-439,共3页Chinese Journal of Burns

摘　　要：目的观察跨中线肩胛游离皮瓣修复手、足大面积软组织缺损的效果。方法根据肩胛区皮肤及微血管解剖特点设计跨中线肩胛区双叶游离皮瓣,采用该皮瓣修复手、足热压伤及脱套伤患者9例。观察患者术后皮瓣成活情况、血供、色泽、弹性,以及有无瘢痕挛缩、功能障碍等。结果手术中旋肩胛血管水平支和降支形成的皮瓣最大面积各为31 cm×14 cm、22 cm×16 cm,皮瓣超越脊柱中线达10 cm。9例患者皮瓣全部成活,无血运障碍,创面修复后弹性好。随访2～14个月,患者手、足皮瓣修复区皮肤色泽及弹性较好,无瘢痕挛缩,功能恢复良好。结论跨中线肩胛双叶游离皮瓣是修复手、足大面积软组织缺损较理想的方法。Objective To evaluate the result of free transmidline bi-lobed scapular skin flap transplantation to repair massivesoft tissue defects in upper and lower extremities. Methods Free transmidline bi-lobed scapular skin flap was designed according to the characteristics of scapular skin and its vasculature, and they were used to repair massive soft tissue defects in upper and lower extremities as a result of hot crush injury and avulsion injury in 9 patients. The survival of the flap, the blood supply, the color and elasticity of the flap, as well as scar contraction and impairment in function were observed after operation. Results The largest flap formed with the horizontal branch and descending branch circumflex scapular artery were 31 × 14 cm and 22 × 16 cm, respectively. The horizontal branch went across the spinal midline for 10 cm. All skin flaps survived with good elasticity and without necrosis. The grafted skin was excellent in the appearance and elasticity, with no scar contracture , and function of the injured extremities recovered well 2 to14 months after the operation. Conclusion Free transmidline bi-lobed scapular skin flap is an ideal procedure for the repair of massive soft tissue defects in upper and lower extremities.

关 键 词：外科皮瓣 创伤和损伤 创面修复 

分 类 号：R658[医药卫生—外科学]