带蒂髂腹股沟皮瓣在修复中老年上肢软组织缺损中的应用  

Application of pedicled iliac inguinal flap in the repair of soft tissue defects in the upper extremities of the middle-aged and elderly patients

作　　者：朱振兴 缪玉龙 邓智明 邵志恩 潘健鹏 ZHU Zhenxing;MIAO Yulong;DENG Zhiming(Department of Hand and Foot Surgery, Changshu City Second Peopled Hospital,Changshu, Jiangsu, 215500, China)

机构地区：[1]江苏扬州大学附属常熟市第二人民医院手足一科

出　　处：《实用手外科杂志》2019年第2期162-164,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨带蒂髂腹股沟皮瓣在治疗中老年上肢软组织缺损中的临床效果。方法 2013年8月-2017年12月,应用带蒂髂腹股沟皮瓣移植修复中老年上肢软组织缺损31例,其中手部软组织缺损24例,前臂缺损7例;软组织缺损面积在5 cm×6 cm^8 cm×14 cm。其中合并高血压19例,糖尿病11例,室性早搏4例,脑梗后遗症1例,低蛋白血症3例。结果 31例皮瓣全部成活,2例出现皮瓣蒂部伤口感染,经换药后愈合,余伤口均Ⅰ期愈合。31例均得到随访,随访时间为6~24个月,平均14.5个月。其中3例因手掌侧皮瓣臃肿于术后6个月予皮瓣整形,余28例皮瓣外观、质地均较满意,患肢肩、肘功能恢复良好,无明显关节僵硬等并发症。结论带蒂髂腹股沟皮瓣有手术简单、风险小、成活率高等优点,对于一些要求保肢治疗的中老年患者,是一种优先选择的手术方式,也适合一些基层医院开展。Objective To investigate the clinical effect of pedicled iliac inguinal flap in the treatment of upper extremity soft tissue defects in middle-aged and elderly patients. Methods From August 2013 to December 2017, 31 cases of middle-aged and elderly patients were treated with pedicled ilioinguinal skin flap transplantation to repair upper limb soft tissue defects, including 24 cases of hand soft tissue defects and 7 cases of forearm defects. The area of soft tissue defect was 5 cm×6 cm ~ 8 cm× 14 cm. There were 19 cases of hypertension, 11 cases of diabetes, 4 cases of ventricular premature beats, 1 case of sequelae of cerebral infarction and 3 cases of hypoproteinemia. Results All the flaps survived in 31 patients, and 2 patients had wound infection on the pedicle of the flaps. After dressing change, the remaining wounds healed in stage Ⅰ. All 31 patients were followed up for 6 to 24 months, with an average of 14.5 months.Among them, 3 cases were treated with palmar flaps 6 months after operation. The appearance and texture of the remaining 28 cases were satisfactory. The shoulder and elbow functions of the affected limbs recovered well without obvious joint stiffness and other complications. Conclusion Pedicled ilioinguinal skin flap has the advantages of simple operation, low risk and high survival rate. It is a preferred surgical method for some middle-aged and elderly patients requiring limb salvage treatment, and it is also suitable for implementation in some primary hospitals.

关 键 词：带蒂髂腹股沟皮瓣 中老年 外科 软组织缺损 

分 类 号：R658.2[医药卫生—外科学]