游离腹股沟皮瓣修复手部组织缺损  

Repair of hand tissue defect with free inguinal skin flap

作　　者：宋永岗 王学志[1] 于勇华 邹永根 罗旭超 欧昌良 Song Yonggang;Wang Xuezhi;Yu Yonghua;Zou Yonggen;Luo Xuchao;Ou Changliang(Department of Orthopedics,Yibin Third People9 s Hospital,Yibin,Sichuan 644000;Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]宜宾市第三人民医院骨科,四川宜宾644000 [2]西南医科大学附属中医医院,四川泸州646000

出　　处：《创伤外科杂志》2022年第6期424-427,共4页Journal of Traumatic Surgery

摘　　要：目的 探讨游离腹股沟皮瓣修复手部组织缺损的临床疗效。方法 回顾性分析2016年1月—2020年1月宜宾市第三人民医院骨科应用以旋髂浅动脉为血供的腹股沟皮瓣修复手部组织缺损患者30例,男性21例,女性9例;年龄25~57岁,平均40.2岁;均为机械压砸致伤,手背部18例,手掌部12例;急诊手术修复5例,择期手术25例。创面清创后均伴有肌腱、骨骼等深部组织外露,皮瓣缺损面积3.0cm×3.0cm~6.0cm×7.5cm,皮瓣切取面积3.5cm×3.5cm~6.0cm×8.0cm。皮瓣供区均采用美容缝合。门诊定期随访。结果 皮瓣顺利成活27例,术后24h内出现动脉栓塞2例,经手术探查后血管再通畅,皮瓣完全成活;皮瓣远端少许坏死1例,经换药后愈合。随访时间3~12个月,平均10.5个月,皮瓣色泽良好,质地可,外形美观,供区美容缝合后仅留线性瘢痕。根据手外科上肢功能评定标准进行评定优18例,良12例。结论 游离腹股沟皮瓣修复手部组织缺损,供区隐蔽,穿支较恒定,易于解剖,修复手部组织缺损,外形美观,具有良好的临床疗效。Objective To investigate the clinical efficacy of free inguinal flaps for repairing hand tissue defects.Methods From Jan.2016 to Jan.2020,30 cases of hand tissue defects were retrospectively analyzed,who were repaired by using inguinal flaps with superficial circumflex iliac artery as the blood supply in the Department of Orthopedics of the Third People’s Hospital of Yibin City.There were 21 males and 9 females,with an average of 40.2 years(range,25 to 57 years).The causes of injuries were all mechanical crush injuries,including 18 cases on the back of the hand and 12 cases on the palm.There were 5 cases of emergency surgical repair and 25 cases of elective operation.After debridement of the wound,deep tissues such as tendons and bones were exposed.The flap defect area was 3.0cm×3.0cm-6.0cm×7.5cm,and the flap area was 3.5 cm×3.5 cm-6.0 cm×8.0 cm.The skin flap donor area was sutured cosmetically.Regular follow-up visits was conducted in outpatient clinics.Results Twenty-seven cases of skin flaps survived successfully.Arterial embolism occurred in 2 cases within 24 hours after operation.After surgical exploration,the blood vessels were re-opened,and the skin flaps survived completely.One case was slightly necrotic at the distal end of the skin flap,which healed after dressing change.The follow-up time ranged from 3 to 12 months,with an average of 10.5 months.The flaps had good color,good texture,and beautiful appearance.Only linear scars remained after cosmetic suture in the donor site.According to the evaluation criteria of upper limb function in hand surgery,18 cases were excellent and 12 cases were good.Conclusion The free inguinal flap for repairing hand tissue defects,which has concealed donor site,relatively constant perforators,and is easy to dissect.The repair of hand tissue defects has beautiful appearance and good clinical efficacy.

关 键 词：软组织损伤 腹股沟 皮瓣修复 手部 

分 类 号：R658.2[医药卫生—外科学]