腹部S形瓦合皮瓣修复手指皮肤脱套伤  

Repair of finger degloving injury with S-shaped over and out abdominal flap

作　　者：石定 刘宗义[1] 宋永斌 马芮 荣向科[1] 徐春娟[1] SHI Ding;LIU Zongyi;SONG Yongbin(Department of Burn and Plastic Microsurgery,The 987th Hospital of The Joint LogisticsSupport Force of PLA,Baoji,Shanxi,721000,China)

机构地区：[1]中国人民解放军联勤保障部队第987医院烧伤整形显微外科,陕西宝鸡721000

出　　处：《实用手外科杂志》2024年第4期456-459,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨腹部S形瓦合皮瓣修复手指皮肤脱套伤的手术方法及临床效果。方法2020年2月-2023年3月,中国人民解放军联勤保障部队第987医院应用腹部S形瓦合皮瓣修复手指皮肤脱套伤22例。创面面积:3.0 cm×1.5 cm~7.0 cm×4.5 cm,单个皮瓣切取面积:3.5 cm×2.0 cm~7.5 cm×5.0 cm。术后通过门诊、电话以及微信随访。结果在22例44块皮瓣中,3块皮瓣感染,二期愈合;其余41块皮瓣及22例皮瓣供区均一期愈合。术后随访4~25个月,平均5.8个月。术后3个月时,3例皮瓣臃肿,1例指尖部皮瓣萎缩,其余18例皮瓣外观饱满,色泽正常,无明显臃肿。评估手功能:优12例,良6例,可3例,差1例,优良率81.8%;供区无影响。结论采用腹部S形瓦合皮瓣修复手指皮肤脱套伤,具有操作简单、成活率高、创面修复满意等优点,且明显减少了供区皮肤软组织损失,是一种值得临床推广的手术方式。Objective To explore the surgical method and clinical effect of repairing finger skin degloving injury with S-shaped over and out abdominal flap.Methods From February 2020 to March 2023,the 987th Hospital of the Joint Logistics Support Force of PLA applied S-shaped over and out abdominal flaps to repair 22 patients with finger skin degloving injuries.Wound area:3.0 cm×1.5 cm~7.0 cm×4.5 cm,single flap size:3.5 cm×2.0 cm~7.5 cm×5.0 cm.Postoperative follow-up was performed through outpatient,telephone,and WeChat/internet.Results Among 44 flaps in 22 cases,3 were infected and healed in stage Ⅱ,while the remaining 41 healed in stage Ⅰ.All 22 donor areas healed in stage Ⅰ.The postoperative follow-up time was 4-25 months,with an average of 5.8 months.Three months after surgery,3 cases of skin flap was bloated,1 case of fingertip part of skin flap had atrophy,and the remaining 18 flaps had a plump appearance,normal color,and no obvious corpulence.Evaluation of hand function:12 cases were excellent,6 cases were good,3 cases were fair,and 1 case was poor,with an excellent and good rate of 81.8%;The flap donor area had recovered well.Conclusion The use of S-shaped over and out abdominal flap for repairing finger skin degloving injury has the advantages of simple operation,high survival rate,satisfactory wound repair,and significantly reduces the loss of skin and soft tissue in the donor area.It is a surgical method worth of promoting.

关 键 词：指损伤 外科皮瓣 脱套伤 伤口愈合 

分 类 号：R658.2[医药卫生—外科学]