个性化设计游离皮瓣精准修复手、腕部热压伤创面的疗效观察  

Observation on the clinical efficacy of personalized design of free skin flap for precise repair of hand and wrist thermal compression wounds

作　　者：吕文涛 蒋国栋 张庆阳 巨积辉 侯绍鹏 杨元 程俊楠 李建宁 葛成伟 Lyu Wentao;Jiang Guodong;Zhang Qingyang;Ju Jihui;Hou Shaopeng;Yang Yuan;Cheng Junnan;Li Jianning;Ge Chengwei(Department of Hand Surgery,Suzhou Ruihua Orthopedic Hospital,Suzhou 215104,China)

机构地区：[1]苏州瑞华骨科医院手外科,苏州215104

出　　处：《中华手外科杂志》2024年第4期320-324,共5页Chinese Journal of Hand Surgery

基　　金：苏州市民生科技项目(SS202092)。

摘　　要：目的探讨个性化设计游离皮瓣精准修复手、腕部热压伤创面的临床疗效.方法自2013年1月至2021年11月,我们对32例手、腕部热压伤患者,根据部位、程度及创面大小,结合患者不同需求,应用个性化设计游离皮瓣精准修复单纯手指创面15例,单纯手掌部创面3例,单纯腕部创面3例,手掌合并手指创面4例,手掌合并腕部创面3例,手掌合并手指及腕部创面4例.皮瓣切取面积为2.0cm×1.5 cm~30.0cm×8.0cm,皮瓣供区采用直接缝合或植皮,均于伤后1~3周内手术.结果术后本组32例55块皮瓣全部存活,均获得随访,时间为6个月至6年,平均14个月.皮瓣色泽红润,质地柔软,外形不臃肿(21块皮瓣行皮瓣修薄),肢体功能恢复良好.皮瓣温、痛、触觉恢复,两点分辨觉为5~11 mm,平均8 mm;未重建感觉皮瓣均恢复保护性感觉.结论根据热压伤部位、程度及创面大小,个性化设计游离皮瓣,精准修复手、腕部创面,治疗更具针对性,可以获得满意的效果.Objective To explore the clinical efficacy of personalized design of free skin flaps for precise repair of hand and wrist thermal compression injuries.Methods From January 2013 to November 2021,32 patient with hand and wrist thermal compression injuries were treated.Based on the location,degree,and size of the wound,combined with the different needs of patients,personalized design of free skin flaps was applied to accurately repair 15 cases of simple finger wounds,3 cases of simple palm wounds,3 cases of simple wrist wounds,4 cases of palm combined finger wounds,3 cases of palm combined wrist wounds,and 4 cases of palmar combined finger wounds,3 cases of palmar combined wrist wounds,and 4 cases of palm combined finger and wrist wounds.The incision area of the skin flap was 2.0 cm×1.5 cm to 30.0 cm x 8.0 cm.The donor area of the skin flap was directly sutured or skin graft,and surgery was performed within 1 to 3 weeks after the injury.Results After surgery,all 55 skin flaps from 32 patients in this group survived and were follow-up for a period of 6 months to 6 years,with an average of 14 months.The skin flap had a rosy color,a soft texture,and a non-bulky appearance(21 skin flaps were thinned).The limb function was well restored.The temperature,pain,and tactile sensation of the skin flap recovered,with a two-point discrimination of 5 to 11 mm and an average of 8 mm.The skin flaps without reconstructed sensation all restored protective sensation.Conclusion Based on the location,severity,and size of the thermal compression injury,personalized design of free skin flaps can accurately repair hand and wrist wounds,resulting in more targeted treatment and satisfactory results.

关 键 词：外科皮瓣 显微外科手术 热压伤 精准修复 

分 类 号：R658.2[医药卫生—外科学]