腹股沟皮瓣在手及前臂烧伤遗留瘢痕切除后创面修复中的应用  

Application of Inguinal Flap in the Repair of Wound after Scar Excision from Hand and Forearm Burns

作　　者：潘韦行 严芳 周敏[1] PAN Wei-xing;YAN Fang;ZHOU Min(Department of Burn and Plastic Surgery,Neijiang First People's Hospital,Neijiang 641000,Sichuan,China)

机构地区：[1]内江市第一人民医院烧伤整形科

出　　处：《中国美容医学》2019年第9期53-56,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨腹股沟皮瓣修复手及前臂烧伤遗留瘢痕切除后创面的临床效果。方法:选取2017年1月-2018年2月在笔者医院行手及前臂烧伤遗留瘢痕切除后创面修复的患者105例,根据患者选取的治疗方式分为观察组(n=46)和对照组(n=59)。观察组给予腹股沟皮瓣修复,对照组给予股前外侧皮瓣修复,观察两组皮瓣存活情况,检测血清炎症因子、血管内皮生长因子(VEGF)和缺氧诱导因子-1(HIF-1)水平。结果:观察组皮瓣存活率为95.65%明显高于对照组的79.66%,且观察组抗生素应用时间(6.83±2.11)d明显短于对照组的(9.82±1.80)d,差异有统计学意义(P<0.05)。观察组术后白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)明显低于对照组,且观察组术后7dVEGF明显高于对照组,而HIF-1明显低于对照组,差异均有统计学意义(P<0.05)。观察组术后皮下感染率为4.35%明显低于对照组的18.64%,差异有统计学意义(P<0.05)。结论:游离皮瓣技术在手及前臂烧伤遗留瘢痕切除后创面修复中有较好的效果,其中腹股沟皮瓣修复效果较好。Objective To investigate therapeutic effect of inguinal flap in the repair of wound after scar excision after hand and forearm burns. Methods 105 patients of wound repair after scar excision of hand and forearm burns in our hospital from January 2017 to February 2018 were selected, according to the treatment methods selected by the patients, were divided into the observation group(n=46) and the control group(n=59). The observation group was treated with inguinal flap, while the control group was treated with the anterolateral thigh flap. The survival of skin flaps and so on in the two groups was observed, and the levels of serum inflammatory factors, vascular endothelial growth factor(VEGF) and hypoxia inducible factor-1(HIF-1) were detected. Results The survival rate of skin flaps in the observation group was 95.65% higher than that in the control group(79.66%), and the antibiotic application time in the observation group was(6.83±2.11)d significantly shorter than that in the control group(9.82±1.80)d, the differences were statistically significant(P<0.05). The levels of interleukin-6(IL-6), interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α) in the observation group were significantly lower than those in the control group(P<0.05). The level of vascular endothelial growth factor(VEGF) in the observation group was significantly higher than that in the control group 7 days after operation, while the level of HIF-1 was significantly lower than that in the control group(P<0.05). The rate of subcutaneous infection in the observation group was 4.35%, which was significantly lower than that in the control group(18.64%, P<0.05). Conclusion Free flap technique has a good effect in the repair of wound after scar excision after hand and forearm burns, and inguinal skin flap has a better effect.

关 键 词：游离皮瓣技术 腹股沟皮瓣 股前外侧皮瓣 手 前臂 烧伤后瘢痕 创面修复 

分 类 号：R622[医药卫生—整形外科]