股前外侧穿支皮瓣移植在四肢严重创伤后皮肤缺损修复中的应用  

Application of anterolateral femoral skin flap in the repair of skin defects after severe trauma to extremities

作　　者：沈传新 王光华 侯自明 SHEN Chuan-xin;WANG Guang-hua;HOU Zi-ming(Burn and Plastic Surgery department,PLA 150th Hospital,Henan Province,471000,China;PLA 543th Hospital,Henan Province,471000,China)

机构地区：[1]解放军第150中心医院烧伤整形科,河南洛阳471000 [2]解放军第543医院,河南洛阳471000

出　　处：《中国医疗美容》2018年第3期25-27,共3页China Medical Cosmetology

摘　　要：目的探讨和分析在四肢严重创伤患者的皮肤缺损修复中应用股前外侧穿支皮瓣移植的效果。方法此次抽取2013年1月-2017年6月在我医院治疗的四肢严重创伤皮肤缺损患者(30例)当做分析的对象,此次研究患者均经过股前外侧穿支皮瓣移植进行修复治疗,总结修复情况。结果在此次研究的30例患者中,穿支皮瓣都成活,而且切口良好愈合,皮瓣切除面积在8.0cm×9.0cm-12.1cm×22.3cm之间。有3例患者的皮肤边缘出现坏死,在酒精擦拭、敷药后愈合;11例患者的皮神经吻合效果不佳,19例患者的皮神经成功吻合;在术后给予患者半年随访,发现供区都恢复正常,也没发生畸形和肌力下降。而有3例患者的皮肤感觉存在异常;受区同正常皮肤的差异不明显,未出现坏死、炎症、臃肿、畸形等现象;有3例患者瘢痕比较明显。患者感觉的恢复情况:19例皮神经成功吻合患者中,12例患者S3+,7例患者S2。结论在四肢严重创伤患者的皮肤缺损修复中,股前外侧穿支皮瓣移植的效果确切。Objective To investigate and analyze the effect of transplanted lateral perforator flaps in the repair of skin defects in patients with severe traumatic limbs.Methods The patients with severe traumatic skin defect(30 cases)treated in our hospital from January 2013 to June 2017 were selected as the object of study.The patients were all repaired by transplanted lateral perforating branch flap Treatment,summed up the repair situation.Results In the 30 patients in this study,the perforator flap survived and the incision healed well.The flap excision area was between 8.0cm×9.0cm-12.1cm×22.3cm.Three patients had necrosis on the edge of the skin and healed after alcohol wiping and application.The anastomosis of the cutaneous nerve in 11 patients was not good,and the dermal nerves in 19 patients were successfully anastomosed.Patients were followed up for six months after operation,Are back to normal,nor deformity and decreased strength.However,there were abnormal skin sensation in 3 patients.There was no significant difference between the normal skin and normal skin.No necrosis,inflammation,bloatedness and deformity were observed in 3 cases.Patient perception of recovery:19 cases of successful nerve anastomosis in patients,12 patients with S3+,7 patients with S2.Conclusion In the repair of skin defects in patients with severe traumatic limbs,the effect of transplanted lateral perforator flaps is correct.

关 键 词：四肢严重创伤 皮肤缺损 股前外侧穿支皮瓣 移植 修复 效果 

分 类 号：R658[医药卫生—外科学]