CAJ | 학술논문

目的探讨胸脐皮瓣设计与切取改良的技术.方法皮瓣设计改良:在原来皮瓣设计的基础上,使皮瓣不但包括本侧血管供应的皮肤,还能跨过中线到对侧血管供应的皮肤,达到皮瓣延长,用来修复较长或较宽的创面.切取皮瓣顺序的改良:将原来皮瓣先探察上端胸脐支血管的方法改为先探察下端腹壁下血管存在,满意后再切取上端胸壁段,完成皮瓣的切取.制成薄皮瓣应用:根据需要在皮瓣切取过程中将远2/3削薄；在下腹部血管蒂处的皮瓣1/3不削薄,以保护皮瓣的血供,临床应用54例.结果 54例中,有1例因修复感染创面后皮瓣感染坏死,53例皮瓣成活,成功率98.1％.随访1～5年,皮瓣外观良好,受区关节伸屈活动满意.覆盖软组织感染创面治愈.结论改良的胸脐皮瓣设计合理、切取容易、成功率高、适应证更广泛.
목적 탐토흉제피판설계여절취개량적기술.방법 피판설계개량:재원래피판설계적기출상,사피판불단포괄본측혈관공응적피부,환능과과중선도대측혈관공응적피부,체도피판연장,용래수복교장혹교관적창면.절취피판순서적개량:장원래피판선탐찰상단흉제지혈관적방법개위선탐찰하단복벽하혈관존재,만의후재절취상단흉벽단,완성피판적절취.제성박피판응용:근거수요재피판절취과정중장원2/3삭박；재하복부혈관체처적피판1/3불삭박,이보호피판적혈공,림상응용54례.결과 54례중,유1례인수복감염창면후피판감염배사,53례피판성활,성공솔98.1％.수방1～5년,피판외관량호,수구관절신굴활동만의.복개연조직감염창면치유.결론 개량적흉제피판설계합리、절취용역、성공솔고、괄응증경엄범.
Objective To investigate the technique of design and cutting method of the thoraco- um-bilicus flap.Methods (1) Made the skin flap include not only the vascularity skin of this side,but also the opposite side,to repair overlength and overbreadth wound surface.(2) Improvement of skin flap cutting steps:first to find the blood vessel under the lower abdominal wall,then to cut the skin flap,if not find to have another donor area.(3)Technology of making thin skin flap:when cutting open the skin,made the surgical blade inclined to the flap,beveling to 2/3 of the skin flap length and in hypogastrium cutting to all over the flap with the fat keep stay in the abdomen so to make the skin flap thiner.Results There was 1 case necrosis because of infection in all 54 cases be repaired.The achievement ratio was 98.1％.Follow up with 1-5 years,skin flaps appearance was good,joint extend- bend was gratification.Soft tissue infection was cured.Conclusion Modified technology of thoraco-umbilicus flap is reasonable design and easily to cut,and the achievement ratio is higher.