游离股深动脉第三穿动脉穿支皮瓣修复手部皮肤软组织缺损  

Application of the free perforator flap of the third perforating artery of deep femoral artery for reconstruction of skin and soft tissue defects of hand

作　　者：刘宇 黄雄杰[1] 谢松林[1] 黄新锋[1] 刘昌雄[1] 许云华[1] 王俊方[1] 王九松 宋剑刚[1] 刘鸣江[1] Liu Yu;Huang Xiongjie;Xie Songlin;Huang Xinfeng;Liu Changxiong;Xu Yunhua;Wang Junfang;Wang Jiusong;Song Jiangang;Liu Mingjiang(Department of Hand and Foot Surgery,Nanhua Hospital Affiliated to South China University,Hengyang 421000,China)

机构地区：[1]南华大学附属南华医院手足外科,衡阳421000

出　　处：《中华手外科杂志》2021年第6期458-460,共3页Chinese Journal of Hand Surgery

基　　金：湖南省卫计委科研计划重点项目(A2017018)。

摘　　要：目的探讨游离股深动脉第三穿动脉穿支皮瓣修复手部皮肤软组织缺损的可行性。方法自2016年6月至2018年6月我科应用股深动脉第三穿动脉穿支皮瓣修复手部软组织缺损患者11例。机械伤4例,车祸伤4例,慢性溃疡2例,蛇咬伤1例。创面面积5 cm×7 cm~7 cm×16 cm,所有患者均合并肌腱或骨外露,供区直接缝合。结果 11例皮瓣顺利存活,1例术后出现静脉危象,经探查后皮瓣存活。术后随访3~18个月,平均7.5个月,皮瓣外形无明显臃肿,质地柔软,无色素沉着,功能满意。结论股深动脉第三穿动脉穿支皮瓣皮下脂肪少,穿支恒定,血管蒂8~10 cm,是一种有效修复手部皮肤软组织缺损的方法。Objective To explore the feasibility of repairing skin and soft tissue defects of hand with free perforator flap of the third perforating artery of deep femoral artery.Methods From June 2016 to June 2018,11 patients with hand soft tissue defects were repaired with perforator flap of the third perforating artery of deep femoral artery.There were 4 cases of mechanical injury,4 cases of traffic accident injury,2 cases of chronic ulcer and 1 case of snake bite.The wound area ranged from 5 cm×7 cm to 7 cm×16 cm.All the patients had tendon or bone exposure,and the donor area was sutured directly.Results All the cases survived successfully,1 case had venous crisis,and the flap survived after exploration.The follow-up ranged from 3 to 18 months,with an average of 7.5 months.The flap had no obvious bloated appearance,soft texture,no pigmentation and satisfactory function.Conclusion The perforator flap of the third perforating artery of deep femoral artery has less subcutaneous fat,constant perforating branch and 8 to 10 cm vascular pedicle.It is an effective method to repair the skin and soft tissue defects of hand.

关 键 词：手损伤 外科皮瓣 股深动脉 第三穿动脉 软组织缺损 

分 类 号：R658.2[医药卫生—外科学]