掌背动脉穿支皮瓣修复手部软组织缺损的临床应用  

Clinical application of the dorsal metacarpal artery perforator flap on repair of soft tissue defects in hand

作　　者：王强[1] 谢飞[1] 李刚[1] 成德亮 吕敏[1] 张丽君 魏登科 Wang Qiang;Xie Fei;Li Gang(The Center of Hand Surgery,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学附属红会医院手外中心一病区,710054

出　　处：《美中国际创伤杂志》2018年第4期16-17,27,共3页U.S.Chinese International Journal of Traumatology

摘　　要：目的:手部的创伤及外伤术后导致皮肤软组织坏死和缺损,造成内固定、骨质、肌腱、神经、血管等深部组织外露,为了早期修复创面减少进一步的损伤,其治疗原则是尽量保留肢体长度及功能,应用皮瓣覆盖。选择血供可靠和质地相近的皮瓣可恢复良好的外观、感觉及耐磨性,而供区外观及功能损失尽可能最小。一探讨应用掌背动脉穿支皮瓣修复手部软组织缺损临床体会。方法:2015年8月至2018年9月,对74例手部软组织缺损患者,男68例,女6例;年龄6~65岁。其中机器伤40例,交通致伤20例,重物砸伤14例。应用掌背动脉穿支皮瓣进行修复手部不同类型皮肤软组织缺损创面。结果:术后72例皮瓣成活,2例皮瓣坏死。随访时间6~12个月。皮瓣质地良好,感觉恢复良好,供区植皮愈合良好,轻度色素沉着,耐磨性较好。结论:手部创面修复,遵循了就近取材原则,不同类型手部创面缺损,选择合适的修复方案,适用于手部软组织缺损,尽量选择皮瓣质地、色泽、外观、耐磨度相符,术后外形美观。Objective: Tlie Iraurna of the hand lead to skin soft tissue necrosis and defect, resulting in the exposure of internal fixator or deep tissues such as bone, tendon, nerves, blood vessels, etc. In order to reduce the damage in the early repair of the wound, the principle of treatment is to preserve the function and the length of the limbs as much as possible, and cover the wound with flap. Selecting flaps with reliable blood supply and similar texture can restore good appearance, feel and abradability, while the appearance and function loss of the donor site is minimized. Purpose of this study is to observe the clinical effect of dorsal metacarpal artery perforator flap for repairing the hand soft tissue defects. Methods: From August 2015 to September 2018, 74 patients, including 68 male and 6 female, aged between 6 and 65 years, were treated in our department. Dorsal metacarpal artery perforator flap was used for repairing the different types of skin soft tissue defects on the hands. Among them, there were 40 patients with mechanical injury, 20 patients with traffic injury and 14 patients hit by heavy objects. Results: All cases were followed-up for 6~12 months, the flap survived in 72 cases and necrosis happed in 2 cases. The texture of the flap is good, feeling is well restored, skin graft of the donor site is well healed, good abradability and mild pigmentation was noted. Conclusion: Wound repair for the hands should follow the principle of nearby materials. Different types of the defects need to choose a suitable program. The texture, color, appearance and abradability of the flap should match with the skin as far as possible.

关 键 词：手部 掌背动脉穿支皮瓣 创面修复 

分 类 号：R658.2[医药卫生—外科学]