吻合血管的脐旁皮瓣联合分叶带蒂皮瓣修复手部热压伤  

Repair of heat crushes on the dorsum of hand by the paraumbilical flap with anastomosis of vessles and the distant split-pedicled flap

作　　者：张兴群[1] 赵风景[1] 张龙春[1] 徐一波[1] 陈莹[1] 

机构地区：[1]杭州整形医院手外一科,310014

出　　处：《中华移植杂志（电子版）》2011年第1期42-44,共3页Chinese Journal of Transplantation(Electronic Edition)

摘　　要：目的探讨吻合血管的脐旁皮瓣联合分叶带蒂皮瓣修复手背及指背热压伤的方法。方法切取脐旁皮瓣,近端皮瓣血管蒂与手部鼻烟壶部桡动脉深支及其伴行静脉吻合,皮瓣远端分成四叶瓣并与腹部带蒂相连,以保证指背远侧皮瓣血供。一期分指,重建指蹼,修复手背热压伤。结果皮瓣完全成活,质地柔软,色泽均匀,随访5个月功能及外形均比较满意。结论吻合血管的脐旁皮瓣联合分叶带蒂皮瓣修复手背及指背热压伤,可一期分指,减少了手术次数和瘢痕形成,有利于手部功能及外形的恢复。Objective To explore the surgical method and effect of the paranmbilical flap combined with anastomosis of vessels and the distant sublobe pedicle flap for repairing hot crush injury of the dorsum of hand. Methods A pedicled-paraumbilical flap was incised, and then the inferior epigastric artery and accompanying veins were anastomosed end to end to radial artery and its accompanying veins. The flap was splitted to respectively cover the fingers with pedicles. Finishing separating fingers and reconstructing finger- webs were achieved by fist intention. Results The flap survived and had good color and texture. The appearance and function of the hand was satisfactory after 5-month follow up. Conclusions Paraumbilical flap combined with distal sublobe pedicle flap and proximal anastomosis of vessels can successfully repair hot crush injury of the dorsum of hand with good appearance and function, meanwhile the method can finish seperating fingers by first intention and prevent scar formation.

关 键 词：脐旁皮瓣 带蒂皮瓣 热压伤 显微外科 手外科 修复 组织移植 

分 类 号：R658.2[医药卫生—外科学]