腹部多H形皮瓣联合游离植皮修复多指脱套伤  

Observation on the effect of multiple H-shaped skin flaps of the abdomen combined with free skin grafting in repairing multiple degloving injury

作　　者：吴太东 林跃 詹金昌 WU Taidong;LIN Yue;ZHAN Jinchang(Deparmemt of Hand and Foot Vascular Microsurgery,Dongguan Kanghua Hospital,Dongguan,Guangdong,523083,China)

机构地区：[1]东莞康华医院手足血管显微外科,广东东莞523083

出　　处：《实用手外科杂志》2021年第2期223-225,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨腹部多H形皮瓣修复多指脱套伤的临床疗效及安全性。方法2018年11月-2019年12月,采用腹部多H形皮瓣修复多指脱套伤10例30指,术后4周断蒂,手指皮瓣均采用延期两周缝合,观察创面愈合、皮瓣成活及并发症发生情况。结果术后皮瓣及游离植皮区均成活。皮瓣颜色红润、质地柔软。2例共3指伤口渗出合并感染,经换药处理后恢复。5例12指术后皮瓣较臃肿,6个月后行二期修薄整形术。供区断蒂后均一期愈合。最后一次手术术后6个月参照《中华医学会手外科学会上肢部分功能评定试用标准》评价疗效,优6例,良4例。结论应用多个腹部H形皮瓣联合植皮修复手指脱套伤及皮肤软组织缺损具有简单、安全、可靠、成活率高等优点,值得临床推广应用。Objective To explore the clinical efficacy and safety of multiple H-shaped abdominal flaps in repairing multi-finger degloving injury.Methods From January 2018 to December 2019,10 cases of multi-finger degloving injury were repaired with multiple H type flaps on the abdomen.The pedicle was cut off 4 weeks after the operation,and the finger flaps were sutured with a delay of two weeks.The wound healing,flap survival and complications were observed.Results The flap and the free skin graft area survived.The skin flap is ruddy in color and soft in texture.In 2 cases,3 fingers of wound exuded and had infection,which recovered after dressing change.The skin flaps of 5 cases with 12 fingers were bloated after operation,and the second-stage thinning plastic surgery was performed 6 months later.All donor sites healed by first intention after pedicle cutting.Six months after the last operation,the efficacy was evaluated according to the"Chinese Medical Association Hand Surgery Society Upper Extremity Part Function Evaluation Trial Standard".The evaluation was excellent in 6 cases and good in 4 cases.Conclusion The application of multiple abdominal"H"flaps combined with skin grafting to repair finger detachment injuries and skin and soft tissue defects has the advantages of simplicity,safety,reliability,and high survival rate,and is worthy of clinical application.

关 键 词：腹部皮瓣 H形皮瓣 多指脱套伤 

分 类 号：R658.2[医药卫生—外科学]