改良胸脐皮瓣修复四肢超长软组织缺损  

Improvement of thoracic umbilical flap repair the extremity giant soft-tissue defects

作　　者：刘宏波[1] 朱军 董娜[1] 王建国[1] 窦洪磊[1] Liu Hongbo;Zhu Jun;Dong Na;Wang Jianguo;Dou Honglei(Department of Traumatic Osteopathic, the Yidu Central Hospital of Weifang, Weifang 262500, China)

机构地区：[1]潍坊市益都中心医院骨科,262500

出　　处：《中华整形外科杂志》2019年第5期476-478,共3页Chinese Journal of Plastic Surgery

摘　　要：目的探讨改良胸脐皮瓣修复四肢超长软组织缺损的临床效果。方法 2012年4月至2017年3月,潍坊市益都中心医院骨科收治7例四肢超长创面患者,男5例,女2例,年龄29~51岁,平均43岁。其中上肢创面4例,下肢创面3例。利用腹壁下动脉走行至腹壁上动脉,再走行至肋间动脉或侧胸动脉的双重"链式供血"这一血供基础,设计并切取仅吻合一组血管的跨胸腹供区超长胸脐皮瓣,对7例四肢超长软组织缺损进行修复。结果 7例皮瓣全部成活,皮瓣切取范围30 cm×9 cm^45 cm×13 cm。6例获得随访,时间3个月至1年,平均6个月,皮瓣颜色接近周围皮肤,质地柔软,5例患者皮瓣和周围皮肤基本平齐或略厚2~3 mm,1例患者因自身肥胖皮瓣稍显肿胀,但对肢体功能无影响,患者对外观均较满意。结论改良胸脐皮瓣设计合理、切取方便、成活率高,可有效地修复四肢超长缺损创面。Objective To investigate the clinical outcome of modified thoracic umbilical flap, spanning chest and abdomen, in repairing large soft-tissue defect of limbs. Methods From April 2012 to March 2017, 7 patients with large soft-tissue defects of limbs were admitted in the Department of Traumatic Osteopathic, Yidu Central Hospital of Weifang. The patients include 5 males and 2 females, aged from 29 to 51 years, with the mean age of 43 years. Four patients had upper limb soft-tissue defect and 3 patients were lower limb. All limbs large soft-tissue defects were treated by ultra-long thoracic umbilical flaps, spanning chest and abdomen. Epigastric artery and intercostal arteries or lateral thoracic artery were included in the flap to provide double blood supply with only one vascular anastomosis. Results All 7 flaps(30 cm×9 cm-45 cm×13 cm) survived. The followed-up period was 3 months to 1 years. There was no necrosis or infection in tendon and bone observed. The texture of flaps in 5 patients were similar to surrounding skin, or slightly thickened by 2-3 mm. One patient had slightly bloated flap due to obesity, but had no effect on limb function. All patients were satisfied with the outcome. Conclusions Modified thoracic umbilical flap is an reasonable design for the repairment of large soft-tissue defect of limbs, and easily to carry out.

关 键 词：外科皮瓣 胸脐皮瓣 软组织缺损 修复 改进 

分 类 号：R658[医药卫生—外科学]