游离上臂外侧穿支皮瓣修复手足部电烧伤创面  

Repair of wound on hand or foot due to electrical burn using free lateral upper arm perforator flap

作　　者：张丕红[1] 张明华[1] 谢庭鸿[1] 周捷[1] 任利成[1] 梁鹏飞[1] 曾纪章[1] 黄晓元[1] 

机构地区：[1]中南大学湘雅医院烧伤重建外科,长沙410008

出　　处：《中华烧伤杂志》2013年第5期424-426,共3页Chinese Journal of Burns

摘　　要：目的观察游离上臂外侧穿支皮瓣修复手足部电烧伤创面的效果。方法2010年6月-2013年6月，笔者单位收治手足部Ⅲ度电烧伤患者6例，创面大小：6．0cm×4.0cm-8．5cm×7．5cm。采用游离上臂外侧穿支皮瓣修复创面，皮瓣面积为9cm×4cm-12cm×9cm。5例供区拉拢缝合，1例供区移植腹部全厚皮。结果1例中指受损患者术后因皮瓣静脉回流障碍坏死，经换药后取腹部全厚皮移植修复；其余5例皮瓣全部成活，皮瓣颜色和弹性与受区较匹配，臃肿不明显。随访6—24个月，手足部功能恢复尚可，5例患者手功能评定结果：优2例、良2例、差1例。供瓣区瘢痕较轻，无明显功能障碍，效果较佳。结论游离上臂外侧穿支皮瓣血管蒂相对较长，脂肪组织较少，是修复手足部电烧伤小创面的较佳皮瓣。Objective To observe the effect of free lateral upper arm perforator flap in repairing wound on hand or foot due to electrical burn. Methods Six patients with full-thickness wounds on hand or foot resulting from electrical burn were hospitalized from June 2010 to June 2013. The wounds ranged from 6.0 cm× 4.0 cm to 8.5 cm × 7.5 cm in area. Free lateral upper arm perforator flaps were used to repair these defects, with flap area ranging from 9 cm ×4 cm to 12 cm ×9 cm. The donor sites in five cases were closed by suturing; the other one donor site was closed by transplantation of full-thickness skin from abdo- men. Results One flap used to repair the wound in middle finger failed due to failure of venous return, and it was repaired with full-thickness skin harvested from abdomen after dressing change. The other five flaps survived resulting in good elasticity and matched appearance of the recipient area without obvious bulki- ness. Patients were fallowed up for 6 to 24 months. The function of the injured hands or feet recovered well, and the results of function evaluation of five hands were excellent in 2 cases, good in 2 cases, and poor in 1 case. Little scar formation with no contraction or function impairment was observed on donor site, and the re- sult was satisfactory. Conclusions Free lateral upper arm perforator flap, with long vessel and less adi- pose tissue, is suitable for repairing small but deep wound on hand or foot due to electrical burn.

关 键 词：烧伤 电 手 足 外科皮瓣 创面修复 

分 类 号：R644[医药卫生—外科学]