旋髂浅动脉穿支蒂轴型皮瓣修复手腕部软组织缺损临床疗效  

Clinical effect of axial flap pedicled with perforator of superficial iliac circumflex artery in repairing soft tissue defect of wrist

作　　者：李伟[1] 冯小辉 胡晓宇 曹能力[1] 陈亚伟[1] 刘建惠[1] LI Wei;FENG Xiao-hui;HU Xiao-yu;CAO Neng-i;CHEN Ya-wei;LIU Jian-hui(DepartmentⅡof Hand and Microsurgery,Zhengzhou Orthopaedics Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院手外科显微骨科Ⅱ,郑州450052

出　　处：《医药论坛杂志》2023年第11期59-61,65,共4页Journal of Medical Forum

摘　　要：目的分析旋髂浅动脉穿支蒂轴型皮瓣修复手腕部软组织缺损的手术特点和临床疗效。方法2010年11月至2020年5月选取郑州市骨科医院收治的72例手腕部软组织缺损、骨外露患者,急诊一期或择期行旋髂浅动脉穿支蒂轴型皮瓣术,术前创面彻底清创,设计同侧旋髂浅动脉穿支蒂轴型皮瓣修复覆盖创面,皮瓣面积最小为6 cm×4 cm,面积最大为20 cm×15 cm。皮瓣供区创面直接缝合或取皮植皮,术后3周皮瓣断蒂。观察皮瓣血供、成活情况、颜色、感觉及耐磨性,手腕部伤口炎症控制情况,皮瓣供区愈合情况等。结果术后72例皮瓣均顺利成活,其中2例皮瓣最远端小面积坏死,换药后愈合。皮瓣供区伤口均一期愈合。术后随访12~36个月,平均24个月,手腕部伤口愈合良好,无炎性渗出,皮瓣质地柔软,颜色接近手腕部皮肤40例,发暗32例,供区愈合良好。20例患者皮瓣臃肿,经过再次手术修薄,所有皮瓣形态良好,但是耐磨性差。结论旋髂浅动脉穿支蒂轴型皮瓣切取方便,血供丰富,成活率高,外形设计自由,供区损伤小,是一种修复手腕部软组织缺损的有效方法。Objective To analyze the surgical characteristics and clinical effects of axial flap pedicled with perforator of superficial iliac circumflex artery in repairing soft tissue defect of wrist.Methods From November 2010 to May 2020,72 cases of wrist soft tissue defect and bone exposure were treated by emergency or elective operation.The wound was debrided thoroughly before operation,the minimum flap area was 6 cm×4 cm and the maximum flap area was 20 cm×15 cm.The inguinal flap was sutured directly or skin graft was taken,and the pedicle was severed three weeks after op-eration.Skin blood supply,survival,color,sensation and wear resistance,wrist wound inflammation control,skin flap donor area healing were observed.Results There were 72 flaps survived,2 flaps distal part of the epidermis necrosis,wound healing after dressing change.All wounds in donor site healed in one stage.Follow-up ranged from 12 months to 36 months(average 24 months).The wounds of the wrists healed well without inflammatory exudation.The skin flaps were soft in texture,similar in color to the skin of the wrists in 40 cases,darkening in 32 cases,and the donor site healed well.All the 20 cases with bloated skin flaps were thinned by reoperation.All the flaps were in good shape,but the wear resistance was poor.Conclusion The axial flap pedicled with the perforator of superficial iliac circumflex artery is a good method to repair the soft tissue defect of wrist.

关 键 词：旋髂浅动脉 轴型 穿支皮瓣 手 缺损 骨外露 

分 类 号：R622[医药卫生—整形外科]