前臂桡侧复合血管网皮瓣的临床应用  

Clinical application of radial composite vascular net flap of forearm

作　　者：丁小珩[1] 方光荣[1] 姜凯[1] 屈志刚[1] 王振军[1] 程国良[1] 

机构地区：[1]中国人民解放军第四○一医院手外科,青岛市266071

出　　处：《中华显微外科杂志》2004年第1期8-9,F001,共3页Chinese Journal of Microsurgery

摘　　要：目的　报道前臂桡侧神经血管复合岛状皮瓣的解剖方法及临床应用效果。　方法　对手部创面及瘢痕挛缩以该皮瓣进行修复 2 2例 2 3处 ,切取皮瓣面积最大 13cm× 6cm ,最小 8cm× 4cm ,旋转点至皮瓣顶端最长 2 2cm ,旋转点设计在鼻烟窝或其近端 ,蒂部及皮瓣下筋膜中含有桡神经浅支、头静脉及桡动脉鼻烟窝上行支 ,含或不含前臂外侧皮神经。　结果　临床应用 2 2例 2 3块皮瓣 ,其中皮瓣全部成活 2 2块 ,部分坏死 1块。术后随访 1～ 3个月 ,成活的皮瓣质地优良 ,外观比较满意。　结论　前臂桡侧复合皮瓣的临床应用 ,皮瓣切取面积大 ,旋转点更远 ,可达手部较远端创面 ,给手部创面的修复提供了一种新选择。Objective To introduce the anatomic method and effect of application of radial composite vascular net flap of forearm. Methods Twenty-three lesion sites in 22 patients with hand wound or scar contracture were repaired or reconstructed with this flap. The sizes of flaps were 13cm×6cm to 8cm×4cm. The longest distance from pivot point to the tip of the flap was 22 cm. The pivot point was designed at or proximal to anatomic snuff-box. In the pedicle, the subcutaneous fascia contains cutaneous branches of superficial radial nerve, cephalic vein and ascending branch of radial artery branching in the vicinity of anatomic sunff-box. The lateral antibrachial nerve of musculocutaneous nerve may or may not be included in the pedicle. Result Twenty-two of the 23 flaps survived and the other one had partial necrosis. Examination at 1～3 months postoperative period showed that skin texture of the flap to be good, outward appearance satisfactory. Conclusion In comparison with reversed lateral antibrachial cutaneous nerve islandflap, this composite has the merit of higher survival rate and larger donor area. The pivot point shifts more distally that the flap can reach the wound on distal part of the hand, which offer a new alternative in treatment of hand wound.

关 键 词：外科皮瓣 显微外科 前臂 神经血管复合岛状皮瓣 解剖方法 手部创面 

分 类 号：R622.1[医药卫生—整形外科]