交腹带蒂皮瓣在手残端不规则缺损创面中的应用  

Application of cross abdominal flap in multi-dimensional wound of hand stump

作　　者：赵伟超 范红旗[1] 陶忠生[1] 魏斌[1] 考树均 任路通 刘晋阳 ZHAO Weichao;FAN Hongqi;TAO Zhongsheng(Department of Orthopedics Third Ward,The 82nd Group Military Hospital of PLA,Baoding,Hebei,071000,China)

机构地区：[1]中国人民解放军陆军第82集团军医院骨三科,河北保定071000

出　　处：《实用手外科杂志》2025年第1期48-50,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨交腹带蒂皮瓣修复手不同平面毁损离断后,残端不规则创面的临床疗效。方法回顾性分析2013年1月-2022年6月收治的21例手不同平面毁损离断伤患者病例资料。根据离断平面及残端创面大小、形态、累及部位的不同,而采用不同切取方式的交腹带蒂皮瓣修复残端缺损创面,腹部供区不植皮直接缝合。结果患者均获得随访,时间12~72个月,平均33个月。21例交腹带蒂皮瓣均成活良好,其中1例皮瓣术后感染,经伤口换药2周后感染控制,无皮瓣坏死。结论交腹带蒂皮瓣作为一种任意皮瓣,腹部供区切取面积大,无固定营养血管限制,供区隐蔽,能修复手各个平面毁损离断后形成的各种不规则创面,最大程度保留肢体残端长度及手的功能,是一种实用、有效、容易开展的手术。Objective To explore the clinical effect of repairing irregular wounds at the residual end of the hand after different plane damage and detachment using a cross abdominal pedicle skin flap.Methods A retrospective analysis was conducted on a total of 21 patients with different levels of hand injuries and dislocations treated from January 2013 to June 2022.According to the different sizes,shapes,and affected areas of the dissection plane and residual wound,different cutting methods of cross abdominal pedicled skin flaps were used to repair residual defect wounds.The abdominal donor area was directly sutured without skin grafting.Results All the patients were followed up for 12-72 months,with an average of 33 months.All 21 cases of cross abdominal pedicled skin flaps all survived well,including 1 case of skin flap infection after surgery.After 2 weeks of wound dressing change,the infection was controlled and no skin flap necrosis was observed.Conclusion As a random skin flap,the cross abdominal pedicle skin flap has a large resection area in the abdominal donor area,no fixed nutrient vessel restrictions,and a concealed donor area.It can repair various irregular wounds formed after the destruction and detachment of various planes of the hand,preserving the length of the limb stump and the function of the hand to the greatest extent possible.It is a practical,effective,and easy to carry out surgical method.

关 键 词：手 外科皮瓣 毁损性离断 残端创面 

分 类 号：R65[医药卫生—外科学]