CAJ | 학술논문

目的探讨腹壁下动脉穿支的体表分布特点,及应用扩张后腹壁下动脉穿支皮瓣修复手部、前臂大面积瘢痕的I临床效果.方法随机选取20例健康成人,应用多普勒血流探测仪探测双侧腹壁下动脉穿支,分析其在体表分布规律.临床应用扩张后腹壁下动脉穿支皮瓣治疗10例爪形手、前臂瘢痕挛缩畸形患者.结果 20例成人,探测范围包括脐上至剑突的下1/3区域、脐下至耻骨联合的上2/3区域,探测出穿支点共425个,其中80%的点位于腹正中线旁1.1～5.8 cm垂线之间.按照Rand分区法:Ⅰ、Ⅱ、Ⅲ区穿支点所占百分比分别为26%、43%、30%.Ⅳ区穿支点罕见.近脐水平线穿支点较其他部位密集,左右两腹部穿支点排列不对称.临床应用10例,1例皮瓣远端出现血运障碍,经换药后愈合;余9例皮瓣全部成活良好.结论应用扩张后腹壁下动脉穿支皮瓣治疗手部大面积瘢痕,皮瓣切取面积大,较薄、不显臃肿,外观美观,是修复手部及前臂大面积瘢痕的一种较好的方法.
목적 탐토복벽하동맥천지적체표분포특점,급응용확장후복벽하동맥천지피판수복수부、전비대면적반흔적I림상효과.방법 수궤선취20례건강성인,응용다보륵혈류탐측의탐측쌍측복벽하동맥천지,분석기재체표분포규률.림상응용확장후복벽하동맥천지피판치료10례조형수、전비반흔련축기형환자.결과 20례성인,탐측범위포괄제상지검돌적하1/3구역、제하지치골연합적상2/3구역,탐측출천지점공425개,기중80%적점위우복정중선방1.1～5.8 cm수선지간.안조Rand분구법:Ⅰ、Ⅱ、Ⅲ구천지점소점백분비분별위26%、43%、30%.Ⅳ구천지점한견.근제수평선천지점교기타부위밀집,좌우량복부천지점배렬불대칭.림상응용10례,1례피판원단출현혈운장애,경환약후유합;여9례피판전부성활량호.결론 응용확장후복벽하동맥천지피판치료수부대면적반흔,피판절취면적대,교박、불현옹종,외관미관,시수복수부급전비대면적반흔적일충교호적방법.
Objective To'explore the distribution of deep inferior epignstric perforator vessel and application of the expanded perforator flap for large sear on hand and forearm. Methods 20 healthy adults were selected to detect the distribution of deep inferior epignstrie perforator vessel. 10 cases with eieatricial constriction on hand and forearm were treated with expanded perforator flap. Results 425 perforator paints were detected on the skin surface of abdomen in 20 adults. 80% of the points are located within the area which is 1.1 ～5.8 cm far from the mid-line of abdomen. According to the Rand method, the percentage of the paints in zone Ⅰ, Ⅱ, Ⅲ were 26%, 43%, and 30%, respectively. There were few points in zone Ⅳ. The area around navel had a high density of points. The paints were distributed asymmetrically at the two sides of abdomen, 10 cases were treated. Vascular deficiency happened at the distal end of one flap. All the other 9 flaps survived. Conclusions The expanded deep inferior epigastric perforator flap is thin and has a large size. It is very suitable for large sear on forearm or hand.