足背为供区的Y型分叶静脉皮瓣修复深Ⅱ~Ⅲ度热压伤致手背复杂软组织缺损的价值  

The Value of Y-shaped Lobulated Venous Flap with Dorsum Pedis as the Donor Site for Repairing Complex Soft Tissue Defects in the Dorsum of the Hand Caused by Deep Ⅱ~Ⅲ Degree Thermal Compression Injury

作　　者：樊友滨 郑华梁 Fan You-bin;Zheng Hua-liang(Hand and Foot Surgery Department of Xiamen Fifth Hospital,Xiamen 361101,Fujian Province,China)

机构地区：[1]厦门市第五医院手足外科,福建厦门361101

出　　处：《罕少疾病杂志》2023年第9期85-87,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨足背为供区的Y型分叶静脉皮瓣修复深Ⅱ~Ⅲ度热压伤致手背复杂软组织缺损的价值。方法 选取2020年5月至2022年6月于本院就诊的深Ⅱ~Ⅲ度热压伤致手背复杂软组织缺损的患者83例,按照供区部位不同,将其分为足背组(n=41)和腹部组(n=42),足背组采用足背为供区修复手背复杂软组织缺损,腹部组采用腹部游离皮瓣为供区修复手背复杂软组织缺损,比较两组患者围术期指标(手术时长、住院时长、术后每日平均渗血量、创面愈合时间),术后1周,比较两组患者皮瓣血运(颜色、温度、肿胀程度),术后1个月进行随访,通过手部关节活动测量表评估两组患者的手部关节恢复程度,比较两组患者的术后并发症(瘢痕痉挛、皮瓣边缘坏死、局部缺血坏死)发生率。结果 足背组的手术时长、术后平均每日渗血量和创面愈合时间均显著低于腹部组(P<0.05),足背组和腹部组的住院时长无显著统计学差异(P>0.05),术后1周时,足背组和腹部组患者的皮瓣颜色、皮瓣温度和肿胀程度均无统计学差异(P>0.05),术后1个月时,足背组患者的腕关节、大拇指、示指、中指、环指和小指的手部关节活动分数均显著高于腹部组,差异具有统计学意义(P<0.05),足背组患者瘢痕痉挛的发生率显著低于腹部组,差异有统计学意义(P<0.05),两组患者的皮瓣边缘坏死和局部缺血坏死均无显著统计学差异(P>0.05)。结论 足背为供区的Y型分叶静脉皮瓣修复深Ⅱ~Ⅲ度热压伤致手背复杂软组织缺损可有效改善患者的围术期指标,能减少其手术时长且促进创面愈合,有效促进手部关节恢复并降低其并发症发生率,有利于患者预后。Objective To explore the value of Y-shaped lobulated venous flap with dorsum pedis as the donor area for repairing complex soft tissue defects in the dorsum of the hand caused by deep Ⅱ~Ⅲ degree thermal compression injury.Method:A total of 83 patients with complex soft tissue defects in the back of the hand caused by deep Ⅱ to Ⅲ degree thermal pressure injury who were treated in our hospital from May 2020 to June 2022 were selected.They were divided into the dorsum pedis group(n=41)and the abdominal group(n=42)according to the different donor sites.The dorsum pedis group used the dorsum pedis as the donor site to repair complex soft tissue defects in the back of the hand,while the abdominal group used the abdominal free flap as the donor site to repair complex soft tissue defects in the back of the hand,Compare the perioperative indicators(surgical duration,hospital stay,average postoperative daily blood leakage,and wound healing time)between two groups of patients.One week after surgery,compare the blood flow of the flap(color,temperature,and degree of swelling)between the two groups of patients.Follow up will be conducted one month after surgery to evaluate the degree of hand joint recovery between the two groups of patients using the hand joint activity measurement table,Compare the incidence of postoperative complications(scar spasms,flap edge necrosis,and local ischemic necrosis)between two groups of patients.Results showed that the surgical duration,average postoperative daily blood leakage,and wound healing time of the dorsum pedis group were significantly lower than those of the abdominal group(P<0.05).There was no statistically significant difference in hospital stay between the dorsum pedis group and the abdominal group(P>0.05).At one week after surgery,there was no statistically significant difference in skin flap color,skin flap temperature,and swelling degree between the dorsum pedis group and the abdominal group(P>0.05).At one month after surgery,the wrist joint,thumb,index finger The hand j

关 键 词：γ型分叶静脉 手背软组织缺损 皮瓣修复 热压伤 

分 类 号：R274.3[医药卫生—中医骨伤科学]