腹腔镜网膜瓣游离移植并I期植皮修复上肢组织缺损六例  

Repair of soft tissue defect of upper limb with free greater omentum flap transplantation under laparo- scope and primary skin-grafting： report on 6 cases

作　　者：李仕国[1] 夏冬雪[1] 常兴华[1] 王小乐[1] 王志军[1] 

机构地区：[1]大连大学附属新华医院手足外科,辽宁大连116021

出　　处：《中国美容整形外科杂志》2013年第1期22-24,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：【摘要】目的探讨大网膜游离移植修复手及前臂背侧软组织缺损的手术方法及临床效果。方法对受区创面行清创术，去除污染失活组织，探查损伤组织，明确损伤程度，游离解剖桡动脉及其伴随静脉备用。采用全身麻醉，在腹腔镜的辅助下游离网膜左右动脉，结扎离断血管后取出大网膜备用；将大网膜置于创面内，修剪桡动脉及胃网膜左右动脉及部分静脉，显微镜下吻合动静脉，然后将大网膜组织固定于创面内，表面植皮覆盖，加压包扎。结果6例患者术后10d去除加压包，皮肤完全成活。结论采用腹腔镜下微创裁剪大网膜血管组织游离移植修复手背及前臂背侧创面切实可行，成活率高，外观满意。Abstract： Objective To study the surgery of free greater omentum transplantation with laparoscope to the hand and forearm in order to repair soft tissue defects. Methods Recipient site preparation included wound debridement and removing contaminated inactivation organization, probing damaged tissue, dissecting ra- dial artery and vein out with spare. Donor site preparation included exposing stomach retinal artery ligation, li- gating blood vessels and removing greater omentum with spare under general anesthesia with laparoscope. After putting greater omentum into the wound, radial artery and cephalic vein were interanastomosised with stomach retinal artery and vein by microscope, then the greater omentum organization was fixed inside the defect, the surface was covered by skin-grafting. Results After 10 days, 6 cases, the grafted skin and the greater omen- turn organization survived completely. Conclusion Minimally invasive obtaining the greater omentum tissue owe to the laparoscope, free transplantation to repair the forearm and dorsal defect is feasible, and the survival rate is high with a satisfactory appearance.

关 键 词：组织缺损 修复 大网膜 游离移植 腹腔镜 

分 类 号：R658.2[医药卫生—外科学]