CAJ | 학술논문

目的探讨腹壁下动脉穿支皮瓣(deep inferior epigastric perforator flap,DIEP皮瓣)切取方式的改进,扩大DIEP皮瓣的临床应用范围.方法采用双腹壁下血管蒂仅带肌袖的DIEP皮瓣(并可通过筋膜蒂携带髂骨或肋骨)修复四肢大面积软组织缺损,其中前臂缺损5例,手腕部缺损6例,创面面积为10.0 cm×5.0 cm～45.0cm×20.0 cm,均为急诊修复.结果术后11例皮瓣中全部存活10例,大部分存活1例.随访时间3～61个月,皮瓣愈合良好,手功能恢复满意.所有供区均未发生腹壁疝.结论改良DIEP皮瓣是修复大面积皮肤缺损的首选皮瓣之一.
목적 탐토복벽하동맥천지피판(deep inferior epigastric perforator flap,DIEP피판)절취방식적개진,확대DIEP피판적림상응용범위.방법 채용쌍복벽하혈관체부대기수적DIEP피판(병가통과근막체휴대가골혹륵골)수복사지대면적연조직결손,기중전비결손5례,수완부결손6례,창면면적위10.0 cm×5.0 cm～45.0cm×20.0 cm,균위급진수복.결과 술후11례피판중전부존활10례,대부분존활1례.수방시간3～61개월,피판유합량호,수공능회복만의.소유공구균미발생복벽산.결론 개량DIEP피판시수복대면적피부결손적수선피판지일.
Objective To improve the techniques of harvesting the deep inferior epigastric perforator (DIEP) flap and broaden the clinical application of the flap. Methods A modified DIEP flap (or DIEP osteofasciocutaneous flap with iliac or rib) involving perforating vessels of the bilateral deep inferior epigastric vasculature with a muscle cuff was used to cover large defects of the extremities. There were 5 cases of defects of the forearm and 6 cases with defects of the hand and wrist. The areas of the defects were 10.0 cm × 5.0 cm to 45.0 cm × 20.0 cm. All flap transfers were done in the emergent setting. Results 10 of the 11 flaps survived completely while one flap survived with partial necrosis. Follow up ranged from 3 to 61 months. The flaps healed well. Function of the hand was satisfactory. There was no abdominal wall hernia at the donor sites. Conclusion The modified DIEP flap involving bilateral pedicles is the procedure of option for reconstruction of large defects.