远端蒂皮瓣修复肢体远端皮肤软组织缺损  

Repairing Soft Tissue Defect in Extremity with Distal Pedicle Flap

作　　者：蔡晓斌[1] 刘云健[1] 吴凌峰[1] 吴忠伟[1] 

机构地区：[1]温州医学院附属丽水市中心医院,温州丽水323000

出　　处：《实用骨科杂志》2008年第7期398-400,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨应用远端蒂皮瓣修复肢体远端皮肤软组织缺损的临床效果。方法临床应用14种不同类型的远端蒂皮瓣修复肢体远端皮肤软组织缺损共127例。皮瓣类型：指背筋膜蒂皮瓣9例,手指侧方岛状皮瓣25例,掌背动脉逆行皮瓣15例,食指背侧岛状皮瓣8例,桡神经浅支营养血管皮瓣13例,桡动脉鼻烟窝皮支皮瓣6例,尺动脉腕上皮支皮瓣7例,前臂骨间背动脉岛状穿支皮瓣7例,腓肠神经营养血管皮瓣15例,腓肠神经营养血管肌皮瓣4例,隐神经营养血管皮瓣5例,胫后动脉内踝上皮支皮瓣8例,足底内侧逆行皮瓣3例,跖背动脉逆行皮瓣2例。其中血管蒂皮瓣81例,筋膜皮瓣9例,神经营养血管皮瓣37例。结果本组127例均获得随访,随访时间1-6个月,平均3个月,127例远端蒂皮瓣完全成活,皮瓣完全坏死3例,皮瓣远端部分坏死7例。成活的皮瓣外观、质地良好。结论远端蒂皮瓣移位修复肢体远端组织缺损安全、简便、不吻合血管,成功率高,皮瓣较薄,与受区皮肤质地、色泽比较接近等优点,是修复肢体远端软组织缺损较理想的选择。Objective To study the clinical effect of the distal pedicle flap torepair the soft tissue defect in extremity. Methods 14 kinds of different types of distalpedicle flap to repair the soft tissue defect in 137 cases were clinical applied. The types of the flap as follows ：fascio cutaneous flap at the finger＇s reverse side in 9 cases,island flap at the finger＇s side in 25 cases,arteria metacarpea dorsalis skin flap in 15 cases,island skin flap at the dorsi-forefinger in 8 cases,ramus superficialis nervi radialis nutrient vessel flap in 13 cases,arteria radialis anatomicalsnuff-box cutaneous branches flap in 6 cases,arteria ulnaris cutaneous branches flap at wrist in 7 cases, arteria inter-back island perforating branch flap at focile in 7 cases,sural nerve nutriem vessel flap in 15 cases, sural nerve nutrient vessel myocutaneous flap in 4 cases, nervus saphenus nutrient vessel flap in 5 cases,arteria tibialis posteriorinemal malleolus cutaneous branches flap in 8 cases ,footplate wall flyback flap in 3 cases, dorsal metatarsal arteries flyback flap in 2 cases. Among the total ,vascularpedicle skin flap is 84 cases ,anadesma flap is 9 cases ,nervus nutrient vessel flap is 30 cases. Results 137 cases of distal pedicle flap were survived completely, 3 casesof flap were necrosis completely,7 cases of distal flap were necrosis partly. Patients were followed up after operation,the contour and texture of the survival flap were excellent. Conclusion The distal pedicle flap to repair the extremity tissue defect was charactered by advantages of safety,convenient ,not to coincide blood vessel ,high achievement ratio ,thin flap,the texture and colour are similar to the recipient site skin. It is an ideal choice in repairing the soft tissue defect in extremity.

关 键 词：创伤 组织缺损 远端蒂皮瓣 显微修复 

分 类 号：R622.1[医药卫生—整形外科]