CAJ | 학술논문

目的探讨骨间后动脉血管变异时前臂背侧皮瓣的切取方法.方法以骨间后动脉为蒂逆行岛状皮瓣转移修复手部皮肤软组织缺损时,遇到血管变异共9例,采取以骨间后动脉桡侧支为蒂切取逆行岛状前臂背侧皮瓣、以骨间后动脉近端为蒂切取游离骨间后动脉皮瓣、以骨间后动脉穿支为蒂切取游离前臂背侧穿支皮瓣等方法,进行皮瓣转移或移植修复手部创面.结果 9例皮瓣中有8例顺利存活;1例术后2 d皮瓣远端出现肿胀、青紫、小水泡,及时对症处理,5 d后部分皮缘形成干痂,皮瓣颜色恢复正常,脱痂后存活.9例随访3个月至2年,皮瓣质地柔软,弹性好,外形满意.结论以桡骨间后动脉侧支为蒂的前臂背侧皮瓣逆行转移,以骨间后动脉近端或骨间后动脉穿支为蒂的前臂背侧皮瓣游离移植修复手部创面,是解决骨间后动脉血管变异较理想的方法.
목적 탐토골간후동맥혈관변이시전비배측피판적절취방법.방법 이골간후동맥위체역행도상피판전이수복수부피부연조직결손시,우도혈관변이공9례,채취이골간후동맥뇨측지위체절취역행도상전비배측피판、이골간후동맥근단위체절취유리골간후동맥피판、이골간후동맥천지위체절취유리전비배측천지피판등방법,진행피판전이혹이식수복수부창면.결과 9례피판중유8례순리존활;1례술후2 d피판원단출현종창、청자、소수포,급시대증처리,5 d후부분피연형성간가,피판안색회복정상,탈가후존활.9례수방3개월지2년,피판질지유연,탄성호,외형만의.결론 이뇨골간후동맥측지위체적전비배측피판역행전이,이골간후동맥근단혹골간후동맥천지위체적전비배측피판유리이식수복수부창면,시해결골간후동맥혈관변이교이상적방법.
Objective To investigate the methods to harvest dorsal forearm flaps when there exists variations of the dorsal interosseous artery. Methods Variations of the dorsal interosseous artery were encountered in 9 cases during retrogredo transfer of dorsal forearm island flap pedicled on the dorsal interosseous artery to cover soft tissue defect on dorsum of the hand. Several alternative methods were used to complete the flap harvest and transfer, including reverse island dorsal forearm flap pedicled on radial branch of the dorsal interosseous artery, free posterior interosseous reverse flow flap with proximal dorsal interosseous artery as the pedicle, free dorsal forearm perforator flap based on the perforators of the dorsal interosseous artery. Results Eight of the 9 flaps survived. Swelling, cyanosis and blister in the distal portion of the flap occurred in 1 case 2days after the operation. This was treated accordingly. Five days later,eschar formed at the edge of the flap and the flap returned to normal color. Eventually this flap survived after the eschar peeled off. The 9 eases were followed up for 3 months to 2 years. The flaps were soft and elastic. The appearance was satisfactory.Conclusion Reverse island dorsal forearm flap pedieled on radial branch of the dorsal interosseous artery, free posterior interosseous reverse flow flap with proximal dorsal interosseous artery as the pedicle and free dorsal forearm perforator flap based on the perforators of the dorsal interosseous artery are good altematives to deal with dorsal interosseous artery variations during dorsal forearm flap transfer.