游离腹股沟皮瓣修复手部皮肤缺损  

Free groin flap for coverage of soft tissue defect of the hand

作　　者：戚建武[1] 柴益铜[1] 王科杰[1] 蔡利兵[1] 李学渊[1] 王欣[1] 

机构地区：[1]宁波市第六医院手外科,315040

出　　处：《中华手外科杂志》2013年第5期271-273,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨游离腹股沟皮瓣修复手部皮肤缺损的临床疗效。方法对9例手部皮肤软组织缺损采用游离腹股沟皮瓣移植修复，切取面积为12．0cm×8．0cm～7．5cm×6．0cm。术中修剪皮瓣边缘部分脂肪组织；旋髂浅动脉与桡动脉终末支吻合6例，与指总动脉吻合3例；8例同时修复一根伴行静脉和一根皮下静脉，1例仅修复一根伴行静脉。结果1例吻合一根伴行静脉的皮瓣，于术后第2天出现静脉危象，经对症处理保守治疗后，皮瓣表皮坏死，皮下软组织成活，二期予植皮术。余8例皮瓣全部顺利存活。随访3个月至1．5年，皮瓣质地软，稍臃肿，感觉恢复至S2～s3，腹部供区瘢痕小。结论利用游离腹股沟皮瓣移植修复手部皮肤软组织缺损，供区能直接缝合，且部位隐蔽，瘢痕小。较常规带蒂皮瓣减少了手术次数，缩短了治疗时间，是修复手部皮肤软组织缺损较好的方法。Objective To discuss the clinical results of the free groin flap in treating skin and soft tissue defect of the hand. Methods The free groin flap was used to treat 9 cases of skin and soft tissues defects of the hand. The size of the flaps ranged from 12.0 cm× 8.0 cm to 7.5 cm× 6.0 cm. The fatty tissue at tile edge of the flaps was trimmed before flap transfer. Reperfusion of the flap was established by anastomosing the superficial iliac circumflex artery to the terminal branch of the radial artery in 6 cases and to the common digital artery in 3 cases. Flap drainage was through one concomitant vein and one subcutaneous vein in 8 cases and through only one concomitant vein in 1 case. Results Venous crisis occurred in the case with only one concomitant vein anastomosed 2 days postoperatively. Conservative treatment preserved the subcutaneous tissue of the flap with skin necrosis that needed secondary skin graft. All other 8 flaps survived uneventfully. The patients were follow-up for 3 to 18 months. The flaps were soft with good texture, but slightly bulky. Sensation of the flaps recovered to S2 to S3. The scar at the abdominal donor site was small. Conclusion Free groin flap is a good option for treatment of soft tissue defects of the hand. The donor site is hidden and the scar is small. It has one less operation than pedicled flaps and thus shortens the course of treatment and relieves patient burden.

关 键 词：外科皮瓣 手损伤 组织移植 

分 类 号：R658.2[医药卫生—外科学]