窄蒂肋间穿支型薄皮瓣在手背创面修复中的应用  

NARROW PEDICLED INTERCOSTAL CUTANEOUS PERFORATOR THIN FLAP FOR COVERAGE OF SKIN DEFECT OF HAND/

作　　者：高建华[1,2] 罗锦辉[1,2] 百束比古 颜玲[1,2] 张立宪 文入正敏[1,2] 

机构地区：[1]第一军医大学南方医院整形外科 [2]日本医科大学附属病院形成外科

出　　处：《中国修复重建外科杂志》1996年第3期149-151,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：介绍一种以肋间动脉皮肤穿支为营养血管的、主要用于修复手背皮肤缺损的薄皮瓣。手术方法是以第４～９肋间血管外侧皮穿支为蒂，蒂部长和宽均为３～５ｃｍ，瓣部长宽均可达１５ｃｍ，远端２／３修薄。术后第７～１０天断蒂。应用此窄蒂皮瓣修复１５例１６只手背创面，皮瓣全部成活。随访６个月～２年，手功能恢复良好。由于手术不需分离肋间主干血管，其操作远较以往报道的岛状或游离肋间血管皮瓣简便和安全。The narrow pedicled intercostal cutaneous perforater (np ICP) thin flaps were successfully used for reconstruction of hand deformity from scar contraction. This flap was designed with a narrow pedicle (3～5cm in width) which included ICPs of 4th～9th intercostal spaces, and with a wide distal part (the maximum is 15cm×15cm) which covered the lower chest and upper abdomen. The thickness of flap was cut until the subdermal vascular network was observed. The pedicle was divided between the 7th～14th days after operation. Sixteen flaps in 15 cases were transferred for covering of the skin defects at the dorsum of the hand. The perforators which were included in the narrow pedicle were mostly from the 7th intercostal spaces in 9 flaps. Fifteen of the 16 flaps were survived almost completely, except in one case there was necrosis of the distal portion of the flap. It seemed that this flap was more useful than the conventional methods, not only functionally but also aesthetically. Moreover, the operative techinque was more simple and safer than the island or free intercostal flap due to without the necessity to dissect the main trunk of the intercostal neurovascular bundle. Gentle pressure on the thinning portion of the flap for a short time after operation was important.

关 键 词：肋间穿支皮瓣 手皮肤缺损 窄蒂皮瓣 

分 类 号：R658.205[医药卫生—外科学]