游离、带蒂皮瓣外科修复术在小腿皮肤组织缺损中的应用研究  

Application of free and pedicled skin flaps to repair lower leg skin defects

作　　者：陈星元 邬俊夫 张世锦 于恩停 CHEN Xingyuan;WU Junfu;ZHANG Shijin;YU Enting(Department of Bone Surgery,The Sixth People's Hospital of Longgang District of Shenzhen City,Shenzhen 518117,Guangdong,China)

机构地区：[1]深圳市龙岗区第六人民医院骨外科,广东深圳518117

出　　处：《外科研究与新技术》2022年第1期9-13,共5页Surgical Research and New Technique

基　　金：深圳市龙岗区2020年度医疗卫生科技计划项目(LGKCYLWS2020192)。

摘　　要：目的探讨游离、带蒂两种外科皮瓣在修复小腿皮肤组织缺损的临床修复应用。方法回顾性分析2017年9月—2020年9月110例外科皮瓣修复小腿皮肤组织缺损的临床应用,根据皮瓣类型将患者分为游离组和带蒂组。分别就患者术中、术后的情况进行分析,了解两组患者接受治疗后的差异。结果游离组患者的手术时间长于带蒂组患者5 h以上,且术中出血量也多于带蒂组患者(P<0.05)。此外,游离组患者术后出现挛缩的发生率高于带蒂组患者,组间差异具有统计学意义(P<0.05),同时两组患者术后小腿治疗区域的感觉恢复较好,未出现较大偏差。从生存曲线可以看出,两组患者的皮瓣存活率都较高,其中带蒂组患者的存活率略高于游离组患者。结论两种皮瓣修复小腿皮肤组织缺损的应用效果都能够满足需求,其中游离皮瓣的适应性更强,而带蒂皮瓣的操作性更强,治疗效果也稍好。Objective To explore the clinical application of free and pedicled skin flaps in the repair of lower leg skin defects.Methods A retrospective analysis of 110 cases of lower leg skin defects repaired by skin flap from September 2017 to September 2020 were conducted.According to the type of skin flap,the patients were divided into a free group and a pedicled group.The intraoperative and postoperative conditions of the patients were analyzed respectively to understand the difference between the two groups of patients after receiving treatment.Results The operation time of the free group was longer than that of the pedicled group by more than 5 h,and the amount of intraoperative blood loss was more than that of the pedicled group(P<0.05).In addition,the incidence rate of postoperative contractures in the free group was higher than that in the pedicled group,and the difference between the groups was statistically significant(P<0.05).At the same time,the postoperative sensory recovery in the treated area of the lower leg was good in the two groups,with no big deviation.It could be seen from the survival curve that the flap survival rates of the two groups of patients were high,and the survival rate of the pedicled group was slightly higher than that of the free group.Conclusion Both flap repairing methods for lower leg skin defects are effective.Free flap is more adaptable,while pedicled flap is more manipulative and more effective.

关 键 词：外科皮瓣修复手术 小腿皮肤组织缺损 游离皮瓣 带蒂皮瓣 

分 类 号：R622[医药卫生—整形外科]