含脐旁皮动脉真皮下血管网皮瓣修复前臂及手部外伤的应用  

Efficacy of paraumbilical artery pedicle skin flap with subdermal vascular plexus in repairing hand and foream injury

作　　者：胥学冰[1] 史昌乾 崔晓林[1] 张博[1] 张桂全[1] 

机构地区：[1]武警辽宁总队医院烧伤分院,沈阳110034

出　　处：《武警医学》2008年第7期635-637,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的总结含脐旁皮动脉真皮下血管网皮瓣修复前臂及手部软组织缺损的临床疗效。方法回顾分析1999年7月。2007年3月应用含脐旁皮动脉真皮下血管网皮瓣修复前臂及手部软组织缺损创面87例，41例为手部、前臂热压伤，22例为手及前臂电接触损伤，12例手及前臂烧伤，12例为其他原因致伤。手术依创面情况选择皮瓣大小，最大切取面积25cm×8cm，长宽比1．5-4：1，修薄皮下脂肪保留1-3mm。结果72例皮瓣完全成活，11例皮瓣远端小部分坏死，经换药后愈合，4例大部分坏死；或皮瓣与受区撕脱，再次手术。术后随访4个月-2年，受区皮肤平整，色泽好，质地软，外形美观，功能恢复满意。术后3个月。1年有触觉及痛温觉恢复。结论应用脐旁皮动脉真皮下血管网皮瓣修复前臂及手部软组织缺损具有疗程短，术后手及前臂外形及功能恢复良好，是较理想的一种修复方法。Objective To study the efficacy of paraumbilical artery pedicle skin flap with subdermal vascular plexus in repairing forearm and hand injury with defect of skin and soft fissue.Methods From July 1999 to March 2007, the paraumbilical artery pedicle skin flap with subdermal vascular plexus was used to repair the wound surface of forearm and hand with defect of skin and soft tissue in 87 patients （65 males, 22 females,age ranging from 15 to 60）. The causes of forearm and hand injury included hot crush injury in 41 cases, electric burn in 22 cases,bum in 12 cases, and others in 12 cases.The pedicle skin flap was selected depending on the surface condition of injury.The maximal area of flap was 25 cm×8 cm and length-width ratio was 1.5-4：1. Subcutaneous fat was trimmed and maintained the thickness of 1 to 3 mm. Results Skin flaps fully survived in 72 cases. A small kart of skin flap in distal end developed necrosis in 11 cases, but recovered fidly after changing dressing on the wound surface. A majer port of skin flap developed necrosis or was tom off from the recipient site in 4 cases, which needed operation again. Follow-up was conducted for 4 months to 2 years. The skin of the recipient site was smooth and integrated, with satis- factory color and luster, soft texture, and good appearance. The hand function was significantly recovered. Senses of touch, pain and temperature were recovered 3 months to 1 year after operation. Conclusions To repair of the defect of skin and soft tissue in the forearm and hand injury by using paraumbilical artery pedicle skin flap with subdermal vascular plexus has the advantiges of shorter course of treatment, better functional recovery and good appearance. It is an ideal method for repairing the forearm and hand fruama with defect of skin and soft tissue.

关 键 词：含脐旁皮动脉真皮下血管网皮瓣 手及前臂 修复 

分 类 号：R622[医药卫生—整形外科]