游离皮瓣移植修复手部及前臂皮肤缺损的临床效果  

CLINICAL EFFECT OF FREE SKIN FLAP GRAFT ON REPAIRING SKIN DEFECT OF HAND OR FOREARMARM

作　　者：马爱国[1] 张文龙[1] 赵刚[1] 侍朋举[1] 张铁山[1] 李亮[1] 

机构地区：[1]河北省唐山市第二医院,063000

出　　处：《中国煤炭工业医学杂志》2015年第5期723-726,共4页Chinese Journal of Coal Industry Medicine

基　　金：河北省医学科学研究重点课题计划项目(ZD20140403)

摘　　要：目的观察游离皮瓣移植修复手部及前臂皮肤缺损的临床效果。方法 2012年6月—2015年2月就诊的90例游离皮瓣移植修复前臂以及手部皮肤缺损患者,根据血管吻合方式将其分为A组(34例)、B组(22例)、C组(34例)三组,A组患者行常规游离植皮,B组则采取手术放大镜下缝线法实施血管吻合,C组采取显微镜下缝线法实施血管吻合,观察三组皮瓣长度、动脉吻合时间、缺血时间、静脉吻合时间以及总血管吻合时间,并对研究结果作统计学分析。结果本组90例患者均成功修复,修复成功率为100.0%;术后随访发现患者移植皮瓣处弹性良好,血运以及质地较佳。足部皮瓣以及足趾组织瓣(不同类型)移植修复的手指以及拇指外观良好,其中指腹两点分辨觉最低为5mm,最高为8mm。与A、B二组相比,C组皮瓣长度更短,动脉吻合时间、缺血时间、静脉吻合时间以及总血管吻合时间更短,组间差异具有统计学意义(P<0.05)。结论在手部以及前臂皮肤缺损修复方案中,游离皮瓣移植是其中较为理想的一种方法,特别在显微镜下缝线法实施血管吻合的效果更佳,值得推广使用。Objective To observe the clinical effect of repair skin defect of hand or forearm by free skin flap graft. Methods Totally 90 cases of free flap transplantation to repair the forearm and hand skin defect patients selected as subjects from June 2012 to February 2015 in author＇s hospital, they were divided into group A （34 cases）, group B （22 cases） and group C （34 cases） according to the different vascular anastomosis way. Group A of patients were received conventional free skin graft, group B with surgical suture method under a magnifying glass was taken to implement vascular anastomosis, group C with implement vascular anastomosis microscopic suture method. Length of three groups of flap, artery anastomosis time, ischemia time, vein anastomosis time and total vascular anastomosis were observed and compared. Results Totally 90 patients were all successful repair, repair success rate was 100.0% ; Postoperative follow- up of patients transplanted flap elastic were good, the blood supply and the quality of a material were better. Foot skin flap and toes tissue flap （different types） transplantation to repair the finger and thumb showed a good appearance, including stomach two tell rain. 5 mm, up to 8 mm. Compared with groupA and group B, group C flap length was shorter, its artery anastomosis, ischemia time, vein anastomosis time and total vascular anastomosis time were also shorter, differences among groups with statistical significance （P〈 0.05）. Conclusions In the hand and forearm skin defect repair scheme, the free flap transplantation is one of the most ideal method, especially under the microscope suture method implementation of vascular anastomosis effect is better. It is worthy of promotion in clinic.

关 键 词：手损伤 外科皮瓣 前臂损伤 组织移植 皮肤缺损 

分 类 号：R681.7[医药卫生—骨科学]