指固有动脉逆行岛状皮瓣术后处理探讨  

Discussion on postoperative management about the reverse digital proper artery island flap

作　　者：向湘华 庄智勇 林乐发 蔡金表 郭超龙 郭传存 XIANG Xianghua;ZHUANG Zhiyong;LIN Lefa(Department of Hand Surgery,Quanzhou Orthopedic-Traumatological Hospital of Fujian TCM University,Quanzhou,Fujian,362000,China)

机构地区：[1]福建中医药大学附属泉州市正骨医院手外科,福建泉州362000 [2]福建中医药大学附属晋江市中医院骨科,福建晋江362201

出　　处：《实用手外科杂志》2020年第4期415-418,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨指固有动脉逆行岛状皮瓣术后两种不同处理方式的临床疗效及术后并发症。方法2013年12月-2019年9月,采用指固有动脉逆行岛状皮瓣治疗手指软组织缺损53例,随机分为观察组27例和对照组26例,观察组术后不要求绝对卧床,允许起床,不使用罂粟碱及抗凝药,不给予烤灯;对照组术后要求绝对卧床,使用罂粟碱及抗凝药物,给予烤灯。对术后不同处理方式的两组从术后血运、褥疮、便秘、尿潴留发生率等方面进行比较观察。结果两组皮瓣均成活,观察组在术后血运方面与对照组比较无明显差异,而观察组术后未发生褥疮,在便秘及尿潴留方面优于对照组,患者住院舒适度更高。结论逆行岛状皮瓣术后不要求绝对卧床,不使用罂粟碱及抗凝药,不给予烤灯保温并不影响皮瓣血运,是一种合理的术后处理方式。Objective To investigate the clinical effects and postoperative complications of two different treatment methods of reverse island flap of digital proper artery.Methods From December 2013 to September 2019,53 cases of finger soft tissue defect treated with reverse island flap of digital proper artery were randomly divided into treatment group(n=27)and control group(n=26).The treatment group did not require absolute bed rest,no papaverine,no anticoagulants,no baking lamp treatment,while the control group required all the above treatments.The two groups were compared and observed from the aspects of postoperative blood circulation,the incidence of bedsore,constipation,urinary retention and so on.Results The flaps of both two groups survived,and there was no significant difference in postoperative blood flow between the treatment group and the control group,but there was no bedsore in the treatment group.What’s more,it was better than that in the control group in terms of constipation and urinary retention,and the hospitalization comfort of the patients was higher.Conclusion After the reverse island flap operation,it does not require absolute bed rest,papaverine,anticoagulant and lamp treatment but does not affect the blood flow of the flap,which is a reasonable postoperative treatment.

关 键 词：逆行岛状皮瓣 缺损 指动脉 创面修复 卧床 

分 类 号：R658.2[医药卫生—外科学]