中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2010年
5期
285-287
,共3页
杨晓东%杨锦%刘杨武%楼旭鹏%丁建波%陈逸民%付尚俊%周阳
楊曉東%楊錦%劉楊武%樓旭鵬%丁建波%陳逸民%付尚俊%週暘
양효동%양금%류양무%루욱붕%정건파%진일민%부상준%주양
外科皮瓣%手损伤%显微外科手术%掌浅弓
外科皮瓣%手損傷%顯微外科手術%掌淺弓
외과피판%수손상%현미외과수술%장천궁
Surgical flaps%Hand injuries%Microsurgery%Superficial palmar arch
目的 探讨应用股前外侧皮瓣游离移植一期修复手掌心毁损创面并重建掌浅弓的临床疗效.方法 2005年3月至2009年12月,对6例手掌心毁损创面应用股前外侧皮瓣游离移植,并重建掌浅弓血管.术中仔细解剖皮瓣及血管蒂,形成以旋股外侧动脉外侧降支为主干及多个分支的血管链,以及以第一穿支为蒂的股前外侧皮瓣.其中皮瓣覆盖创面,血管链及各分支重建掌浅弓,以恢复各手指的血供.结果 术后6例均保留了手掌及手的完整性,皮瓣全部存活,其中1例环指坏死行截指,1例小指远节残端修复,其余各手指血运良好,2例进行二期功能重建与皮瓣修薄手术.随访时间为6~12个月,按中华医学会手外科分会上肢部分功能评定试用标准评定:良3例,可2例,差1例.结论 应用股前外侧皮瓣游离移植一期修复手掌心毁损创面并重建掌浅弓手术,临床效果满意,可以最大限度地减少截指的发生.
目的 探討應用股前外側皮瓣遊離移植一期脩複手掌心燬損創麵併重建掌淺弓的臨床療效.方法 2005年3月至2009年12月,對6例手掌心燬損創麵應用股前外側皮瓣遊離移植,併重建掌淺弓血管.術中仔細解剖皮瓣及血管蒂,形成以鏇股外側動脈外側降支為主榦及多箇分支的血管鏈,以及以第一穿支為蒂的股前外側皮瓣.其中皮瓣覆蓋創麵,血管鏈及各分支重建掌淺弓,以恢複各手指的血供.結果 術後6例均保留瞭手掌及手的完整性,皮瓣全部存活,其中1例環指壞死行截指,1例小指遠節殘耑脩複,其餘各手指血運良好,2例進行二期功能重建與皮瓣脩薄手術.隨訪時間為6~12箇月,按中華醫學會手外科分會上肢部分功能評定試用標準評定:良3例,可2例,差1例.結論 應用股前外側皮瓣遊離移植一期脩複手掌心燬損創麵併重建掌淺弓手術,臨床效果滿意,可以最大限度地減少截指的髮生.
목적 탐토응용고전외측피판유리이식일기수복수장심훼손창면병중건장천궁적림상료효.방법 2005년3월지2009년12월,대6례수장심훼손창면응용고전외측피판유리이식,병중건장천궁혈관.술중자세해부피판급혈관체,형성이선고외측동맥외측강지위주간급다개분지적혈관련,이급이제일천지위체적고전외측피판.기중피판복개창면,혈관련급각분지중건장천궁,이회복각수지적혈공.결과 술후6례균보류료수장급수적완정성,피판전부존활,기중1례배지배사행절지,1례소지원절잔단수복,기여각수지혈운량호,2례진행이기공능중건여피판수박수술.수방시간위6~12개월,안중화의학회수외과분회상지부분공능평정시용표준평정:량3례,가2례,차1례.결론 응용고전외측피판유리이식일기수복수장심훼손창면병중건장천궁수술,림상효과만의,가이최대한도지감소절지적발생.
Objective To investigate the clinical results of one-stage coverage of mutilated palm wound and reconstruction of the superficial palmar arch with anterolateral thigh flap transplantation. Methods From March 2005 to December 2009, 6 cases with mutilating palm injury underwent anterolateral thigh flap transfer to resurface the palmar wound and reconstruct the superficial palmar arch at the same time. The flap and vascular pedicle were dissected carefully to form a vascular chain composed of the trunk of the lateral descending branch of lateral circumflex femoral artery and several muscular branches, and the anterolateral thigh flap pedicled on the first perforator. The flap was inset to cover the wound while the vascular chain with its branches was anastomosed to the superficial palmar arch to restore blood circulation to the fingers. Results Postoperatively all free flaps survived. The integrity of the palm and hand was retained. Other than necrosis of the ring finger in 1 case that was amputated and the little finger in 1 case that required revision, all the fingers recovered good blood circulation. Secondary functional reconstruction and flap debulking were carried out in 2 cases. After 6 to 12months of follow-up the results were graded as good in 3 cases, fair in 2 cases, and bad in 1 case according to the provisional functional assessment criterion for upper limbs issued by the Chinese Hand Surgery Society.Conclusion One-stage coverage of mutilated palm wound and reconstruction of the superficial palmar arch with anterolateral thigh flap transplantation leads to satisfactory clinieal results and minimizes the incidence of finger amputation.