中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2009年
1期
6-9
,共4页
贲道锋%马兵%陈旭林%朱世辉%唐洪泰%路卫%程大胜%肖仕初%夏照帆
賁道鋒%馬兵%陳旭林%硃世輝%唐洪泰%路衛%程大勝%肖仕初%夏照帆
분도봉%마병%진욱림%주세휘%당홍태%로위%정대성%초사초%하조범
烧伤%创伤和损伤%外科皮瓣%修复外科手术
燒傷%創傷和損傷%外科皮瓣%脩複外科手術
소상%창상화손상%외과피판%수복외과수술
Burns%Wounds and injuries%Surgical flaps%Reconstructive surgical procedures
目的 总结采用多个不同类型带蒂皮瓣联合移植修复下肢严重烧、创伤创面的临床经验.方法 1998年1月-2008年9月,第二军医大学长海医院全军烧伤研究所应用20多种轴型血管蒂岛状皮瓣、肌皮瓣、局部筋膜皮瓣等修复236例患者271个下肢烧、创伤深度创面.结果 271个创面用332个带蒂皮瓣修复,术后除1例皮瓣完全坏死、3例边缘淤血坏死经植皮后愈合外,其余皮瓣均完全成活.修复后皮瓣质地柔软,外观稍显臃肿者26例(17例经再次手术削薄),其余患者肢体外形满意.68例功能部位烧、创伤患者术后肢体无挛缩,功能得到不同程度的恢复.结论 带蒂皮瓣能满足下肢烧、创伤深度创面覆盖的需要,根据局部组织损伤程度不同,选用多个皮瓣联合移植,可修复下肢复杂创面.
目的 總結採用多箇不同類型帶蒂皮瓣聯閤移植脩複下肢嚴重燒、創傷創麵的臨床經驗.方法 1998年1月-2008年9月,第二軍醫大學長海醫院全軍燒傷研究所應用20多種軸型血管蒂島狀皮瓣、肌皮瓣、跼部觔膜皮瓣等脩複236例患者271箇下肢燒、創傷深度創麵.結果 271箇創麵用332箇帶蒂皮瓣脩複,術後除1例皮瓣完全壞死、3例邊緣淤血壞死經植皮後愈閤外,其餘皮瓣均完全成活.脩複後皮瓣質地柔軟,外觀稍顯臃腫者26例(17例經再次手術削薄),其餘患者肢體外形滿意.68例功能部位燒、創傷患者術後肢體無攣縮,功能得到不同程度的恢複.結論 帶蒂皮瓣能滿足下肢燒、創傷深度創麵覆蓋的需要,根據跼部組織損傷程度不同,選用多箇皮瓣聯閤移植,可脩複下肢複雜創麵.
목적 총결채용다개불동류형대체피판연합이식수복하지엄중소、창상창면적림상경험.방법 1998년1월-2008년9월,제이군의대학장해의원전군소상연구소응용20다충축형혈관체도상피판、기피판、국부근막피판등수복236례환자271개하지소、창상심도창면.결과 271개창면용332개대체피판수복,술후제1례피판완전배사、3례변연어혈배사경식피후유합외,기여피판균완전성활.수복후피판질지유연,외관초현옹종자26례(17례경재차수술삭박),기여환자지체외형만의.68례공능부위소、창상환자술후지체무련축,공능득도불동정도적회복.결론 대체피판능만족하지소、창상심도창면복개적수요,근거국부조직손상정도불동,선용다개피판연합이식,가수복하지복잡창면.
Objective To summarize the clinical experience in repair of deep burn and traumatic wounds with combined transplantation of different types of pedicled skin flaps in lower extremities. Meth-ods Two hundred and thirty-six patients with 271 deep wounds in lower extremities after burn or trauma were repaired with muscular skin flaps, local fascial flaps and island flaps with vascular pedicle(more than 20 types) in our department from Jan. 1998 to Sept. 2008. Results Complete necrosis of skin flaps oc-curred in 1 case, congestion and necrosis over the edge of skin flaps occured in 3 cases, which were healed after grafting, and other skin flaps survived well with soft texture. Skin flaps were too bulky in 26 cases, a-mong them 17 cases were thinned, and the appearance of other skin flaps were satisfactory. In 68 patients with functional region injury were recovered to certain extent without contracture. Conclusions Skin flaps with pedicles, multiple transplantations if necessary, can repair deep wounds satisfactorily in lower extremi-ties after deep burn or trauma injury.
