上肢皮瓣修复的回顾性研究  

Retrospective study of flap transfer for upper limb repair

作　　者：吴迪[1] 王克利 路来金[1] 宫旭[1] 宣昭鹏[1] 崔建礼[1] 蒋子平[1] 宋良松[1] 孙希光[1] 

机构地区：[1]吉林大学白求恩第一医院手足外科,吉林130031 [2]解放军第二炮兵总医院骨科,北京

出　　处：《中华手外科杂志》2013年第3期170-172,共3页Chinese Journal of Hand Surgery

摘　　要：目的回顾性分析上肢软组织缺损皮瓣修复的手术方法和治疗结果，探讨该类疾病的治疗策略及皮瓣修复后坏死的原因和各类皮瓣的优缺点。方法1997年5月至2012年6月对3650例上肢软组织缺损患者完成37类、3724块皮瓣修复。其中传统皮瓣11类、2471块，带蒂轴型皮瓣10类、1015块，游离皮瓣、肌皮瓣8类、154块。结果术后随访时间为1个月至9年，平均2．4个月。皮瓣完全存活3606块，占96．83％；完全坏死22块，占0．59％；部分坏死96块，占2．58％。结论上肢软组织缺损皮瓣修复必须严格把握适应证，并选择合适的手术时机；逆行岛状皮瓣的静脉回流是影响该皮瓣是否存活的决定因素；皮瓣选择应遵循个体化原则。Objective To explore treatment strategies for upper limb soft tissue defects and the advantages and disadvantages of various flaps and to analyze the causes of flap necrosis through the retrospective analysis of treatment outcomes of upper limb soft tissue defects with surgical flap repair. Methods Surgical treatments were performed in 3650 cases with upper extremity, soft tissue defects from May 1997 to June 2012. 37 types of a total 3724 flaps, including 2471 traditional flaps in 11 types, 1015 pediele flaps in 10 types, 154 free flaps and myocutaneous flaps in 8 types were reviewed. Results All cases were follow-up from 1 month to 9 years, the average being 2.4 months. Complete survival of the flap was seen in 3606 cases, accounting for %.83%. Complete necrosis of the flap occurred in 22 cases, accounting for 0.59%, while partial necrosis occurred in 96 cases, accounting for 2.58%. Conclusion Selection of flap transfer for upper extremity, soft tissue defect should be based on proper surgical indications. Timing of the surgery is also important. Venous drainage of the reverse island flap is the decisive factor for flap survival. Flap choice should be individualized.

关 键 词：上肢 外科皮瓣 软组织缺损 回顾性研究 

分 类 号：R658.2[医药卫生—外科学]