改良尺动脉穿支皮瓣修复手部较大面积皮肤缺损  

Repairing large skin defect of hand with modified ulnar artery perforator flap

作　　者：王辉[1] 王红涛 贾鑫玮 张一晗 王海峰 杨晓溪 WANG Hui;WANG Hong-tao;JIA Xinwei;ZHANG Yihan;WANG Haifeng;YANG Xiaoxi(Department of Hand Surgery,Second Hospital of Tangshan City,Tangshan 063000,China;不详)

机构地区：[1]唐山市第二医院手外科,河北唐山063000 [2]华北理工大学中医学院,河北唐山063210

出　　处：《实用医学杂志》2023年第16期2095-2099,共5页The Journal of Practical Medicine

基　　金：河北省医学科学研究计划项目(编号:20201453);河北省医学适用技术跟踪项目(编号:GZ2021030);唐山市市级科技计划项目(编号:22150219J)。

摘　　要：目的 探讨改良尺动脉穿支皮瓣修复手部较大面积皮肤缺损的临床疗效。方法 回顾性分析2012年9月至2021年8月唐山市第二医院手外科收治且符合选择标准的56例手部较大面积皮肤缺损患者临床资料,根据术中是否吻合皮瓣静脉将其分为改良组30例(2017年2月至2021年8月)和传统组26例(2012年9月至2017年1月)。比较两组患者手术时间、随访时间、住院时间、皮瓣张力性水泡发生率、成活率及末次随访时皮瓣外观的满意度。结果 两组手术均顺利完成。两组患者随访时间差异无统计学意义(P>0.05)。改良组手术时间长于传统组,但住院时间少于传统组、皮瓣张力性水泡发生率低于传统组、皮瓣成活率高于传统组、末次随访患者皮瓣外观满意度好于传统组,差异均有统计学意义(P<0.05)。结论 与传统尺动脉穿支皮瓣相比,吻合静脉的改良尺动脉穿支皮瓣张力性水泡发生率低、成活率高、住院时间短、外形更美观。Objective To investigate the clinical effectiveness of modified ulnar artery perforator flap to repair large skin defect of hand.Methods From September 2012 to August 2021,the clinical data of 56 patients with large skin defect of hand who met the selection criteria in hand surgery department of the Second Hospital of Tangshan were retrospectively analyzed.According to whether the vein of the flap is anastomosed during the operation,they were divided into modified group(30 cases,from February 2017 to August 2021)and traditional group(26 cases,from September 2012 to January 2017).The operation time,follow‑up time,hospital stay,tension blister rate,survival rate of the flaps and patient satisfaction with flap appearance at final follow-up were compared between the two groups.Results All operations were successfully completed in both groups.There was no significant difference of follow‑up time in both groups(P>0.05).The operation time of the modified group was longer than that of the traditional group,but the hospital stay was shorter than that of the traditional group,the incidence of tension blisters of the flaps were lower than that of the traditional group,the survival rate of the flaps were higher than that in traditional group,and patient satisfaction with flap appearance at final follow-up was better than that of the traditional group.There were statistically significant differences in terms of the operation time,hospital stay,tension blister rate,survival rate and appearance satisfaction of the flaps(P<0.05).Conclusion Compared with the traditional ulnar artery perforator flap,the modified ulnar artery perforator flap with vein anastomosis has lower incidence of tension blisters,higher survival rate,shorter hospital stay and better appearance.

关 键 词：外科皮瓣 尺动脉穿支皮瓣 手部皮肤缺损 超回流 静脉吻合 创面修复 

分 类 号：R616.2[医药卫生—外科学]