骨间后动脉近端穿支皮瓣游离移植修复手部软组织缺损  

Reconstruction of soft-tissue defects in hands using the free proximal posterior interrosseous artery forearm perforator flaps

作　　者：王欣[1] 潘佳栋[1] 陈宏[1] 胡浩良[1] 王胜伟[1] 王科杰[1] 章伟文[1] 

机构地区：[1]宁波市第六医院手外科,315040

出　　处：《中华整形外科杂志》2012年第2期83-87,共5页Chinese Journal of Plastic Surgery

基　　金：宁波市自然基金项目（2011A610046）

摘　　要：目的探讨以骨间后动脉近端穿支皮瓣游离移植修复手部软组织缺损的临床疗效。方法择期游离移植修复21例24处手部创面，皮瓣切取面积2．0cm×1．5cm～7．0cm×5．0cm，最大皮瓣长度为9cm。9例在切取皮瓣时解剖出1条浅静脉与受区浅静脉吻合。结果19块皮瓣顺利成活，4块出现水泡，部分变紫，经拆线处理成活，1块皮瓣坏死。术后随访6～25个月，皮瓣色泽与受区相似，无明显臃肿，皮瓣供区瘢痕挛缩不明显。结论以近端穿支血管为蒂的骨间后动脉穿支皮瓣解剖恒定、血供可靠，是修复手部皮肤软组织缺损的良好选择。Objective To investigate the applied anatomy of the proximal posterior interrosseous artery perforator flap （PIAP） and report the clinical results of repairing the soft tissue defects in hands. Methods Between September 2007 and January 2011, 21 patients with 24 soft tissue defects in hands were repaired with the free proximal PIAP flap transplantation. The size of the flaps ranged from 2.0cm×1.5cm～7.0cm×5.0cm. The longest length of these flaps was 9 cm. 9 flaps were dissected with one additional superficial vein to anastomose with the superficial vein at the recipient sites. Results 19 flaps survived completely. Bubbles and violet color happened in 4 flaps which survived finally after partial suture removal. Flap necrosis occurred in one flap. The clinical results were satisfactory after 6-25 months of following-up, and the scars at the donor sites were not obvious. Conclusions The free PIAP flaps have constant, reliable blood supply, and good texture. It is a good option for repairing soft-tissue defects in the hands.

关 键 词：手 损伤 骨间后动脉 穿支皮瓣 移植 

分 类 号：R658.2[医药卫生—外科学]