皮肤扩张器法治疗手套状皮瓣术后重度虎口挛缩  

Application of skin soft tissue expander in the treament of severe contracture of thumb web after glove-flap repair

作　　者：张航 曾福俊 蒋国华 刁杰 刘渝川 刘亚平 唐林俊 何林 张飞飞 ZHANG Hang;ZENG Fu-jun;JIANG Guo-hua;DIAO Jie;LIU Yu-chuan;LIU Ya-ping;TANG Lin-jun;HE Lin;ZHANG Fei-fei(Department of Hand Surgery,Modern Hospital of Sichuan,Chengdu 610041,China)

机构地区：[1]四川现代医院手外科,四川成都610041

出　　处：《中国美容整形外科杂志》2021年第3期133-135,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨采用皮肤扩张器治疗手套状皮瓣术后重度虎口挛缩畸形的临床疗效。方法自2017年2月至2018年10月,四川现代医院手外科采用皮肤扩张器治疗7例手部手套状皮瓣术后导致重度虎口挛缩的患者。一期在皮瓣下埋置50~100 ml的皮肤软组织扩张器1个,术后7~10 d开始注入生理盐水,5~10 ml/次,2次/周,扩张1~2个月;扩张后静置约2周行二期手术,取出皮肤扩张器,开大虎口,利用扩张的皮肤修复虎口创面。结果7例患者术后扩张皮瓣成活良好,切口均一期愈合。随访6~19个月,虎口开大60°~85°,皮瓣血运及质地良好。结论采用皮肤扩张器治疗手部手套状皮瓣术后虎口挛缩畸形,操作简单,是一种解决重度虎口挛缩皮肤不足的较好方法。Objective To explore the clinical efficacy of skin soft tissue expander in the treatment of severe contracture of thumb web after glove-flap repair.Methods From February 2017 to October 2018,7 patients with severe contracture of thumb web after glove-flap repair underwent the treatment of skin soft tissue expander in the Modern Hospital of Sichuan.A skin soft tissue expander of50 ml to 100 ml was embedded under the flap in one-stage.Normal saline was injected into skin soft tissue expander at 7 to 10 days after operation,5 ml to 10 ml each time and twice a week for 1 to 2 months.The second-stage operation was performed after 2 weeks.The skin soft tissue expander was removed and the wounds in thumb web were repaired by expanded skin.Results The expanded flap survived well in 7 patients after operation.All wounds healed in one-stage.All patients were followed up for 6 to 19 months.The angle of thumb web was 60°to 85°.The blood supply and texture of flap was good.Conclusion Application of skin soft tissue expander in the treatment of severe contracture of thumb web after glove-flap repair was simple.It is a good method to solve skin insufficient of severe thumb web contracture.

关 键 词：皮肤扩张器 虎口挛缩 拇指指蹼矫形 

分 类 号：R622[医药卫生—整形外科]