皮瓣修薄法在股前外侧皮瓣游离移植重建血运后的应用  

The application of thin flap repairing method after reascularization in femoral anterolateral free flap

作　　者：庞有明[1] 李武[2] PANG Youming LI Wu(Department of Hand and Foot Surgery, Baotou Steel Hospital, Inner Mongolia, 014010, China)

机构地区：[1]内蒙古包钢医院手足踝外科,内蒙古包头014010 [2]内蒙古医科大学第三附属医院,内蒙古包头014010

出　　处：《实用手外科杂志》2017年第2期202-204,共3页Journal of Practical Hand Surgery

摘　　要：目的 总结皮瓣修薄法在股前外侧皮瓣游离移植重建血运后的应用和疗效.方法 2013年5月-2015年10月,对20例行股前外侧游离皮瓣的患者,采取皮瓣移植至受区,血运重建后“脉络式”分区域Ⅰ期修薄.供区直接缝合8例,取中厚皮片植皮12例.结果 术后皮瓣均成活,发生血管危象2例,皮瓣边缘静脉回流差2例.皮瓣无感染、坏死等并发症发生,供受区创面及切口均Ⅰ期愈合.20例均获随访,随访时间5-24个月,平均15个月.皮瓣质地与周围皮肤接近,耐磨性好,未发生破溃,均未行Ⅱ期皮瓣修整;皮瓣感觉均恢复至S3-S4级;两点辨别觉3.5-6.0 mm,平均5.0 mm.患指功能恢复良好,无挛缩畸形等并发症.末次随访时采用中华医学会手外科学分会上肢部分功能评定试用标准评定疗效,优9例,良5例,可6例;按照Michigan手外科问卷评定标准评定患者对术后皮瓣外观满意度,非常满意9例,满意9例,一般2例.结论 股前外侧皮瓣游离移植重建血运后,Ⅰ期修薄对皮瓣血运影响小,皮瓣外观满意.Objective To summarize the application and effect of thin flap repairing method in femoral anterolateral free flap after reascularization. Methods From May 2013 to October 2015, 20 cases of femoral anterolateral free flap transplantation to the receptor area after reascularization. Donor site sutured directly in 8 cases, taking the middle thickness skin graft in 12 cases. Results All the postoperative flap survived, vascular crisis occurred in 2 cases, flap edge venous return was poor in 2 cases. No complications, such as infection, necrosis of flap occurred. The wound and incision indonor and receptor area was typeⅠhealing. 20 patients had been followed up, 5 ~ 24 months follow-up time, average 15 months. flap and the surrounding skin texture was similar, good wear resistance, no burst, no second flap repair; flap feel recovered to S3 ~ S4 level; two-point discrimination 3.5 ~ 6.0 mm, an average of 5.0 mm. The fingers recovered well without complications such as contracture deformity. In the last follow-up, according to the Chinese Medical Society of Hand Surgery of upper limb portion function assessment criteria to assess the clinical trial, excellent in 9 cases, good in 5 cases, fair in 6 cases;In accordance with the evaluation criteria Michigan Hand Surgery questionnaire assessing patient satisfaction with the appearance of the flaps, very satisfied with the nine cases, satisfactory in 9 cases, general in 2 cases. Conclusion Femoral anterolateral free flap grafting primary thin repair after reascularization has small effects on blood supply, and the flap has a satisfactory appearance.

关 键 词：股前外侧皮瓣 血运重建 皮瓣修薄 

分 类 号：R628[医药卫生—整形外科]