游离股前外侧穿支皮瓣修复手及前臂大面积热压伤创面  

Repair of large area burn and compression injury wounds of the hand and forearm with the free anterolateral perforator flaps

作　　者：汪翔[1] 温贤全 萧志雄[1] 李娟[1] WANG Xiang;WEN Xianquan;XIAO Zhixiong(Department of Hand Surgery,The People's Hospital of Gaoming District Foshan City,Guangdong,Foshan,528500 China)

机构地区：[1]佛山市高明区人民医院手外科,广东佛山528500

出　　处：《实用手外科杂志》2020年第2期170-172,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨游离股前外侧穿支皮瓣修复手及前臂大面积热压伤创面的方法及临床疗效。方法2016年1月-2019年12月,对8例手和前臂热压伤患者急诊行前臂清创,切开焦痂减压,VSD治疗;待创面清洁后,择期行骨折复位内固定术,修复断裂肌腱后,行游离股前外侧穿支皮瓣修复创面。术后定期复查,指导功能康复训练,观察皮瓣的外观、质地、感觉,前臂和手功能及供区的恢复情况。结果术后8例皮瓣及植皮全部成活,1例皮瓣覆盖创面因前臂肌腱坏死、创缘渗出,经换药后愈合。8例均获得随访,随访时间为3~18个月。皮瓣外形美观,不臃肿,质地良好,与受区相似,两点辨别觉12~20 mm;手功能恢复良好,基本恢复正常的生活。结论手和前臂热压伤损伤组织层次深浅不一,常累及多种组织,修复难度大;股前外侧皮瓣解剖恒定,皮肤质地良好,可同时修复不同组织,是修复手及前臂热压伤的一种理想方法。Objective To explore the method and clinical effect of free anterolateral perforator flaps for repairing large area burn and compression injury wounds of hands and forearms.Methods From January2016 to December 2019,8 patients with burn and compression injury wounds of the hand and forearm,debridement of the hand and forearm in emergency department,incision decompression,VSD covering the wound surface,after the wound surface were cleaned,fracture reduction and internal fixation were selected,after the broken tendon were repaired.The anterior lateral perforator flap was used to repair the wound.Regular review after operation,guidance of functional exercise,to observe the appearance and texture,sensation of the flap,the forearm and hand function obtained the recovery of the flap donor site.Results After operation,all 8 flaps and skin grafts survived,and 1 flap wound was necrotized by tendon of the forearm,the wound edge oozed out,and healed after dressing change.All the 8 patients were followed up for 3~18 months.The flaps were beautiful in appearance,not bloated,good in texture and were similar to the recipient area.The two-point discrimination was 12-20 mm.The function of the hand restored well,and the normal life restored basically.Conclusion The large area burn and compression injury involved different levels of damage,often involved a variety of tissues,so it is difficult to repair,the anterolateral perforator flap dissection is constant,good skin texture,which can repair different tissues,it is an ideal method to repair the hand and forearm burn and compression injury.

关 键 词：热压伤 股前外侧皮瓣 手 前臂 创面修复 

分 类 号：R658.2[医药卫生—外科学]