端侧吻合动脉的游离旋髂浅动脉穿支皮瓣修复手部皮肤软组织缺损  

Application of free superficial circumflex iliac artery perforator flap with end to side anastomosis forrepair of hand skin and soft tissue defects

作　　者：戚建武[1] 刘林海[1] 孙斌鸿[1] 柴益铜[1] 薛建波[1] 方炫量[1] 张明华[1] 王欣[1] 陈宏[1] Qi Jianwu, Liu Linhai, Sun Binhong, Chai Yitong, Xue Jianbo, Fang Xuanliang, Zhang Minghua, Wang Xin, Chen Hong(Department of Hand Surgery, Ningbo No.6 Hospital, Ningbo 315040, Chin)

机构地区：[1]宁波市第六医院手外科,315040

出　　处：《中华手外科杂志》2018年第2期87-89,共3页Chinese Journal of Hand Surgery

基　　金：浙江省医药卫生科技计划（2015KYA203）

摘　　要：目的探讨端侧吻合法在游离旋髂浅动脉穿支皮瓣修复手部皮肤缺损中的临床应用和疗效。方法自2012年1月至2016年12月，我们对26例手部皮肤软组织缺损患者采用游离旋髂浅动脉穿支皮瓣移植修复。皮瓣切取面积为5．0cm×8．0cm～9．0cm×20．0cm。术中将旋髂浅动脉及伴行静脉分别与尺动脉或桡动脉及伴行静脉端侧吻合，旋髂浅静脉与头静脉或皮下浅静脉端端吻合。结果术后皮瓣全部顺利存活，随访时间为3～18个月，平均11个月，皮瓣质地柔软、血供好，患肢指体温暖。结论游离旋髂浅动脉穿支皮瓣采用端侧吻合法修复手部皮肤缺损，既保留了受区的主干血管，又解决了皮瓣蒂部血管与受区血管口径不匹配的问题，使皮瓣移植不再受供受区血管口径的限制，术后血管通畅率高，手术风险小。Objective To explore the clinical effects of free superficial circumflex iliac artery perforator flap with end to side anastomosis in the treatment of hand skin and soft tissue defects. Methods From January 2012 to December 2016, 26 cases of hand skin and soft tissue defects were treated by the transplantation of free superficial circumflex iliac artery perforator flap. The area of flap ranged from 5.0 cm×8.0 cm to 9.0 cm×20.0 cm. The superficial iliac circumflex artery and its accompanying vein were anastomosed to the ulnar artery or radial artery and its accompanying vein respectively by end-to- side suture technique. The superficial iliac circumflex vein was anastomosed with the cephalic vein or subcutaneous superficial vein by end-to-end suture technique. Results Postoperatively all the flaps survived uneventfully. The follow-up time was 3 to 18 months, with an average of 11 months. The texture of flap was soft with good blood supply. The fingers of injured limb were warm. Conclusion Free superficial circumflex iliac artery perforator flap with end to side anastomosis is an ideal method for repair of hand skin and soft tissue defects, which not only retains the main vessel of recipient area, but also solves the mismatching of the caliber of the flap pedicle vessel and recipient vessel. The flap transplantation is no longer limited by the caliber of donor and recipient vessels, and has high patency rate and low operation risk.

关 键 词：外科皮瓣 手损伤 旋髂浅动脉 端侧吻合 

分 类 号：R658.2[医药卫生—外科学]