尺动脉腕上皮支皮瓣修复手掌疤痕增生挛缩畸形的临床效果  

Clinical effect of cutaneous branch of ulnar artery on repairing palmar scar hyperplasia and prunus deformity

作　　者：周雅静 朱海涛[1] ZHOU Ya-jing;ZHU Hai-tao(Department of burn orthopedic surgery,Beijing Fengtai Youanmen Hospital,Beijing City,100069,China)

机构地区：[1]北京丰台右安门医院烧伤整形科,北京100069

出　　处：《中国医疗美容》2021年第6期50-53,共4页China Medical Cosmetology

摘　　要：目的探讨尺动脉腕上皮支皮瓣在修复手掌疤痕增生挛缩畸形的临床效果和应用体会。方法2013年6月~2020年6月,我院烧伤整形科共收治14例手掌疤痕增生挛缩畸形的患者,其中男9例,女5例,年龄25~65岁。单纯手掌疤痕增生挛缩畸形患者6例,手掌疤痕增生挛缩畸形伴虎口开大受限患者8例。疤痕松解后创面面积为3.0 cm×8.0 cm~4.0 cm×14.0 cm,皮瓣切取面积为4.0 cm×10.0 cm~5.0 cm×16.0 cm,供瓣区8例直接拉拢缝合,6例部分拉拢缝合缩小创面后于同侧上臂内侧切取全厚皮片移植修复。记录皮瓣成活情况、并发症发生情况、随访情况。结果术后14例皮瓣全部成活,血运良好,供瓣区及上臂供皮区缝合切口均一期愈合,6例供瓣区植皮患者移植皮片均全部成活。术后6个月~3年随访,皮瓣质地、色泽、外形良好,皮瓣感觉部分恢复,手掌外形及功能恢复满意。2例患者因皮瓣轻度臃肿,于术后半年再次行皮瓣削薄手术。结论尺动脉腕上皮支皮瓣具有手术操作简单,皮瓣成活率高,术后外形及功能恢复满意等优点,是改善手掌疤痕增生挛缩畸形较为理想的皮瓣。Objective To investigate the clinical effect and application experience of suprarachial cutaneous branch flap of ulnar artery in repairing scar hyperplasia contracture deformity of palm.Methods From June 2013 to June 2020,a total of 14 patients with palmar scar hyperplasia contracture deformity were treated in the Department of Burns and Orthopaedics of our hospital,including 9 males and 5 females aged 25-65 years.There were 6 patients with simple hand scar hyperplasia contracture deformity and 8 patients with palmar scar hyperplasia contracture deformity accompanied by large limitation of the opening of the jaws.After the release of the scar,the wound area was 3.0cm×8.0cm~4.0cm×14.0cm,and the area of skin differentiation was 4.0cm×10.0cm~5.0cm×16.0cm,8 patients in the area were directly pulled up and sutured,and 6 patients were cut into the ipsilateral medial upper arm for full thickness skin grafting after partial pulling sutured to reduce the wound surface.The survival of the skin flap,the incidence of complications and the follow-up were recorded.Results All the 14 patients survived with good blood supply,the suture incision in donor flap area and upper arm donor area healed in one stage,and all the 6 patients survived with skin graft in donor area.After 6 months to 3 years of follow-up,the texture,color and shape of the flap were good,the sensation of the flap was partially restored,and the shape and function of the palm were satisfactory.Two patients underwent flaps thinning again half a year after surgery due to mild bloatness of the flaps.Conclusion The ulnar artery supracarpal cutaneous branch flap has the advantages of simple operation,high survival rate of skin dance,and satisfactory postoperative appearance and function recovery.It is an ideal skin dance for the improvement of scar hyperplasia contracture deformity of palm.

关 键 词：尺动脉腕上皮支 外科皮瓣 修复 手掌疤痕增生 

分 类 号：R658.2[医药卫生—外科学]