游离腓动脉穿支皮瓣修复手部软组织缺损  

Freeing peroneal artery perforators flap to repair soft tissue defect of hand

作　　者：张海清[1] 余志平 丛海波[1,2] 王晓科 丁英杰 于晓峰 

机构地区：[1]潍坊医学院,山东潍坊261000 [2]威海市中心医院骨外科,山东威海264400

出　　处：《实用手外科杂志》2017年第1期16-18,共3页Journal of Practical Hand Surgery

基　　金：泰山学者工程专项经费资助（项目标号：ts20151110）

摘　　要：目的 探讨游离腓动脉穿支皮瓣修复手部软组织缺损的临床疗效.方法 对2014年8月-2016年1月收治的9例手部软组织缺损患者.以肌间隔、肌皮穿支为蒂,游离腓动脉穿支皮瓣修复创面,供区创面小者可直接缝合,创面较大者取游离皮片植皮修复.结果 9例皮瓣全部成活.随访6~12个月,平均9.4个月,皮瓣质地外观良好,未见明显臃肿及色素沉着.1例在48 h内出现静脉危象,立即手术探查见静脉栓塞,清除后重新吻合皮瓣成活;1例术后1年皮瓣长出寻常疣一枚,手术切除,外观、功能良好.结论 腓动脉的穿支来源相对恒定,皮瓣薄而柔软,可根据手术需要切取不同形状、大小的皮瓣,外形相对美观,解剖分离相对简单,手术创伤小,修复手部软组织缺损临床效果较好.Objective To study the clinical value of freeing peroneal artery perforator flap in the repair soft tissue defect of hand. Methods Retrospective study 9 cases with soft tissue defects of hand from August 2014 to June 2016. With freeing peroneal artery perforators flap to repair wound, the musculocutaneous branch or muscle interval branch was chosen as the vascular pedicle for anastomosis. The donor site was closed directly when it was small, or freeing skin graft processed when it was not. Results All the adipofascial flaps survived uneventfully. Follow-up time ranged from 6 to 12 months, average 9.4 months. The appearance and quality of the adipofascial flap were satisfactory without tumefaction and hyperpig-mentation. The flap＇s venous crisis appeared in 1 case in 48 hours, the DVT was found after search, the flap survived after nastomosed again. In 1 case found a verruca vulgaris, which grew on flap after 1 year, it was survived well after excision. Conclusion Freeing peroneal artery perforators flap has the fairly constant perforator vessel, the simple anatomic and the smaller trauma, it can be designed for different shapes, different size of flap to repair hand soft tissue defect, and good effects can be obtained.

关 键 词：腓动脉 穿支皮辩 软组织缺损 显微外科手术 

分 类 号：R658.2[医药卫生—外科学]