前臂中段尺动脉穿支皮瓣修复腕部电击伤创面  

The middle-forearm flap based on perforator of ulnar artery for electrical burn wound on the wrist

作　　者：储国平[1] 杨敏烈[1] 俞舜[1] 秦宏波[1] 赵庆国[1] 苏青和[1] 吕国忠[1] 

机构地区：[1]无锡市第三人民医院,214000

出　　处：《中华整形外科杂志》2014年第5期346-348,共3页Chinese Journal of Plastic Surgery

摘　　要：目的 探讨前臂中段尺动脉穿支皮瓣修复腕部电击伤创面的临床效果及应用体会.方法 2009年10月至2012年10月,对10例腕部电击伤患者,在前臂内侧近中段,以肱骨内上髁桡侧至豌豆骨桡侧略偏内的连线为皮瓣的轴心线,在轴线中点处,以多普勒血流探测仪探及穿支血管穿皮点为皮瓣旋转点,设计并切取皮瓣逆行转移修复创面,其中保留皮瓣浅静脉并与受区静脉吻合3例;供瓣区直接拉拢缝合2例,移植皮片修复8例.结果 术后10例皮瓣全部成活,但7例未吻合静脉的皮瓣术后2—4d肿胀较明显,1周后均恢复正常;2例皮瓣下组织继发坏死并感染,经换药引流后痊愈.术后随访3 ～36个月,皮瓣色泽、质地良好,无明显臃肿或挛缩现象,患者对治疗效果表示满意.结论 前臂中段尺动脉穿支皮瓣的穿支蒂相对恒定、血供可靠,为腕部电击伤创面的修复提供了一种新的手术选择,尤其适用于尺动脉腕上皮支损伤的腕部偏尺侧创面.To dicuss the application and therapeutic effect of middle-forearm flap based on perforator of ulnar artery for electrical burn wound on the wrist.Methods From Oct.2009 to Oct.2012,10 cases of electrical burn wounds on the wrist were treated.A line from radialis medial epicondyle of humerus to the interior radialis pisiform bone was connected as flap axis.At the midpoint of the line,Doppler flow imaging meter was used to detect the emerging point of perforator vessel.The flap was designed and harvested.The flap was transferred reversely,with superficial vein retaining which was anastomosed with vein at recipient sites in 3 cases.The wounds in the donor sites were closed directly in 2 cases,and with skin graft in 8 cases.Results All the 10 flaps survived completely.7 cases without vein anastomosis underwent obvious flap edema during 2-4 days postoperatively,which resovled 1 week later.Sub-flap tissue necrosis and infection happened in 2 cases,which healed after dressing and drainage.Patients were followed up for 3-36 months with satisfactory results.Conclusions The middle-forearm flap based on perforator of ulnar artery has a stable and reliable blood supply.It offers a new choice for the electric burn wound on the wrist,especially at the ulnar side.

关 键 词：电击伤 腕部 穿支皮瓣 尺动脉 

分 类 号：R658.2[医药卫生—外科学]