五叶皮瓣法治疗轻中度虎口瘢痕挛缩的疗效分析  

5-leaves flap for mild to moderate scar contracture of thumb web:efficacy analysis

作　　者：张兆毅 李子华 黄若强 吕荼 邱忠朋 

机构地区：[1]辽宁省辽阳市中心医院手足显微外科,辽宁辽阳111000

出　　处：《当代医学》2018年第8期9-11,共3页Contemporary Medicine

摘　　要：目的探讨五叶皮瓣法治疗外伤后导致的轻中度虎口瘢痕挛缩的疗效。方法自2011年9月~2017年2月,本院共对收治的24例患者的27侧(3例患者为双手)轻中度瘢痕挛缩的虎口采用五叶皮瓣法进行虎口开大手术,且均不需要植皮,取得了满意的效果。结果术后25组五叶皮瓣一期愈合,2组皮瓣发生部分皮缘坏死,经换药后自行愈合。21名患者的24组皮瓣得到了有效随访,3名患者失访,随访时间5~28个月不等,平均(13.7±0.6)个月。按照侯书健提出的虎口功能评价,术前良者4个,可者15个,差者8个,优良率14.8%;术后优者13个,良者11个,可者3个,优良率88.9%。虎口开大功能评分术前与术后比较,差异有统计学意义(P<0.05)。结论应用五叶皮瓣法治疗轻中度虎口瘢痕挛缩,疗效确切,简单易行,值得临床推广。Objective Discussion the curative effect in the mild to moderate scar contracture of thumb web of trauma. Methods 27 mild to moderate scar contracture of thumb webs of 24 patients(both hands of 3 patients) were treated to expand with 5-leaves flap without dermatoplasty from September 2011 to February 2017 in our hospital, and the treatment effect is satisfactory. Results 25 flaps were survived completely, while 2 flaps had partial necrosis at the edge of flap which healed by dressing change. 24 flaps with 21 cases were effectively follow-up for 5-28 months, with an average 13.7 months, but 3 cases were lost to follow-up. Preoperative: good in 4 cases, poor in 15 cases, bad in 8 cases, and the excellent rate was14.8%; Postoperative: excellent in 13 cases, good in 11 cases, poor in 3 cases, and the excellent rate was 88.9%. Comparison of the scores to expand the thumb web of preoperative and postoperative, the difference was statistically significant(P<0.05), according to Hou Shujian webbed evaluation.Conclusion 5-leaves flap to expand the mild to moderate scar contracture of thumb web: effective, simple, and worthy to promotion in clinical.

关 键 词：五叶皮瓣 瘢痕挛缩 虎口开大 轻中度 

分 类 号：R658.2[医药卫生—外科学]