改良胸脐皮瓣修复软组织缺损54例  

Improvement of thoraco-umbilicus flap repair in 54 cases of soft tissue defect

作　　者：范启申[1] 周祥吉[1] 郑隆宝[2] 高学建[1] 

机构地区：[1]解放军第八十九医院全军创伤骨科研究所,山东省潍坊市261021 [2]解放军第一一七医院骨科

出　　处：《中华显微外科杂志》2011年第5期363-365,I0002,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨胸脐皮瓣设计与切取改良的技术。方法皮瓣设计改良：在原来皮瓣设计的基础上．使皮瓣不但包括本侧血管供应的皮肤，还能跨过中线到对侧血管供应的皮肤，达到皮瓣延长，用来修复较长或较宽的创面。切取皮瓣顺序的改良：将原来皮瓣先探察上端胸脐支血管的方法改为先探察下端腹壁下血管存在，满意后再切取上端胸壁段，完成皮瓣的切取。制成薄皮瓣应用：根据需要在皮瓣切取过程中将远2／3削薄：在下腹部血管蒂处的皮瓣1／3不削薄，以保护皮瓣的血供，临床应用54例。结果54例中，有1例因修复感染创面后皮瓣感染坏死，53例皮瓣成活，成功率98．1％。随访1～5年，皮瓣外观良好，受区关节伸屈活动满意。覆盖软组织感染创面治愈。结论改良的胸脐皮瓣设计合理、切取容易、成功率高、适应证更广泛。Objective To investigate the technique of design and cutting method of the thoraco- umbilicus flap. Methods （1） Made the skin flap include not only the vaseularity skin of this side, but also the opposite side, to repair overlength and overbreadth wound surface. （2） Improvement of skin flap cutting steps： first to find the blood vessel under the lower abdominal wail, then to cut the skin flap, if not find to have another donor area. （3）Technology of making thin skin flap： when cutting open the skin, made the surgical blade inclined to the flap, beveling to 2/3 of the skin flap length and in hypogastrium cutting to all over the flap with the fat keep stay in the abdomen so to make the skin flap thiner. Results There was 1 ease necrosis because of infection in all 54 eases be repaired. The achievement ratio was 98.1%. Follow up with 1-5 years, skin flaps appearance was good, joint extend- bend was gratification. Soft tissue infection was cured. Conclusion Modified technology of thoraeo-umbilieus flap is reasonable design and easily to cut, and the achievement ratio is higher.

关 键 词：胸脐皮瓣 移植 显微外科 

分 类 号：R658.3[医药卫生—外科学]