腹部带蒂皮瓣在上肢皮肤软组织缺损修复中的应用  

Application of abdominal pedicled flap in the repair of skin and soft tissue defects of upper extremity

作　　者：刘小俊 赵瑞 刘云峰 金新源[1] 丁盛 刘蕾 LIU Xiao-jun;ZHAO Rui;LIU Yun-feng;JIN Xin-yuan;DING Sheng;LIU Lei(Department of Burn and Plastic Surgery,North District of Suzhou Municipal Hospital,Suzhou 215000,China)

机构地区：[1]苏州市立医院北区烧伤整形科,江苏苏州215000

出　　处：《中国美容整形外科杂志》2021年第7期415-417,430,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨采用腹部带蒂皮瓣修复上肢皮肤软组织缺损的临床疗效和皮瓣类型选择。方法自2017年1月至2020年11月,苏州市立医院北区烧伤整形科对收治的34例上肢皮肤软组织缺损患者采用腹部任意皮瓣(含真皮下血管网皮瓣)、腹壁浅血管为蒂的轴型皮瓣、脐旁穿支为蒂的穿支皮瓣进行修复,切取皮瓣面积为4 cm×3 cm~45 cm×22 cm。结果32例皮瓣全部成活,2例发生部分坏死。12例二期行皮瓣修薄手术;3例因出现瘢痕挛缩影响手指功能行二期瘢痕矫正,术后手指活动及功能获得改善;余19例均获得一期术后满意效果。随访2~46个月,皮瓣质地柔软,上肢功能及外观较满意。结论采用腹部带蒂皮瓣修复上肢皮肤软组织缺损,因其设计灵活、切取方便、血运可靠、供瓣面积较大,是修复上肢皮肤软组织缺损的一种较理想方法。Objective To explore the clinical efficacy and selection of flap types of abdominal pedicled flap in the repair of skin and soft tissue defects of upper extremity.Methods From January 2017 to November 2020,34 patients with skin and soft tissue defects of upper extremity were hospitalized in the North District of Suzhou Municipal Hospital.Abdominal random flap(including subcutaneous vessel plexus flap),axial flap pedicled with the superficial epigastric artery or paraumbilical perforator flap(PUP)were adopted to cover these soft tissue defects.The area of flap ranged from 4 cm×3 cm to 45 cm×22 cm.Results Partial necrosis occurred in 2 flaps and the remaining flaps survived.The secondary flap thinning procedure was performed in 12 patients.Scar contracture occurred in 3 patients.The movement and function of finger were improved after scar resection.The remaining 19 patients were satisfied with the postoperative efficacy.After the follow-up from 2 to 46 months,the texture of flap was soft and the function and appearance of the upper extremity was satisfactory.Conclusion Due to its viability,convenience,reliable blood supply and large coverage,the abdominal pedicled flap could be an optimal method in the repair of skin and soft tissue defects of upper extremity.

关 键 词：上肢 修复 穿支皮瓣 轴型皮瓣 

分 类 号：R658.2[医药卫生—外科学]