中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2012年
5期
381-383,446
,共4页
手%足%外科皮瓣%显微外科
手%足%外科皮瓣%顯微外科
수%족%외과피판%현미외과
Hand%Foot%Surgical flap%Microsurgey
目的 探讨应用足部多种联合皮瓣修复手部多处多形性皮肤缺损的显微外科修复的临床效果. 方法 2003年9月至2012年1月,临床应用踝前联合足背皮瓣(6例)、足背三叶皮瓣(2例)、跖背联合趾背皮瓣(5例)、联合趾背皮瓣(5例)等一次性修复手部多处多形性皮肤缺损18例,利用携带的腓深神经修复缺损的指神经或指背神经、趾长伸肌腱修复指伸肌腱或指屈肌腱.男15例,女3例,年龄最大56岁,最小15岁,平均32.6岁,手部皮肤缺损为2～3处,面积1.5 cm × 2.0cm～2.5cm×13.0 cm,修复的创面均为骨外露、肌腱外露或缺损. 结果 18例32个皮瓣全部成活,经随访4个月～2年,手指及皮瓣外形良好,色泽正常,神经修复者感觉恢复S2～S3,两点辨别觉在8～ 12mm,肌腱修复者手指屈伸活动可,能胜任日常生活及工作. 结论 应用足部多种联合皮瓣可修复手部多处多形性皮肤缺损.
目的 探討應用足部多種聯閤皮瓣脩複手部多處多形性皮膚缺損的顯微外科脩複的臨床效果. 方法 2003年9月至2012年1月,臨床應用踝前聯閤足揹皮瓣(6例)、足揹三葉皮瓣(2例)、蹠揹聯閤趾揹皮瓣(5例)、聯閤趾揹皮瓣(5例)等一次性脩複手部多處多形性皮膚缺損18例,利用攜帶的腓深神經脩複缺損的指神經或指揹神經、趾長伸肌腱脩複指伸肌腱或指屈肌腱.男15例,女3例,年齡最大56歲,最小15歲,平均32.6歲,手部皮膚缺損為2～3處,麵積1.5 cm × 2.0cm～2.5cm×13.0 cm,脩複的創麵均為骨外露、肌腱外露或缺損. 結果 18例32箇皮瓣全部成活,經隨訪4箇月～2年,手指及皮瓣外形良好,色澤正常,神經脩複者感覺恢複S2～S3,兩點辨彆覺在8～ 12mm,肌腱脩複者手指屈伸活動可,能勝任日常生活及工作. 結論 應用足部多種聯閤皮瓣可脩複手部多處多形性皮膚缺損.
목적 탐토응용족부다충연합피판수복수부다처다형성피부결손적현미외과수복적림상효과. 방법 2003년9월지2012년1월,림상응용과전연합족배피판(6례)、족배삼협피판(2례)、척배연합지배피판(5례)、연합지배피판(5례)등일차성수복수부다처다형성피부결손18례,이용휴대적비심신경수복결손적지신경혹지배신경、지장신기건수복지신기건혹지굴기건.남15례,녀3례,년령최대56세,최소15세,평균32.6세,수부피부결손위2～3처,면적1.5 cm × 2.0cm～2.5cm×13.0 cm,수복적창면균위골외로、기건외로혹결손. 결과 18례32개피판전부성활,경수방4개월～2년,수지급피판외형량호,색택정상,신경수복자감각회복S2～S3,량점변별각재8～ 12mm,기건수복자수지굴신활동가,능성임일상생활급공작. 결론 응용족부다충연합피판가수복수부다처다형성피부결손.
Objective To discuss the clinical effects of the many kinds of combined skin flaps of foot which used for repairing of many places and polymorphous skin defects of hands.Methods This study included 18 patients (15 male and 3 female) with a mean age of 32.6 years (range 15-56 years) between September 2003 and January 2012.The skin defect of hand were 2-3 places and the size of the defect ranged 1.5 cm × 2.0 cm-2.5 cm × 13.0 cm.All of them with bones and tendons exposure or defect.These 18 patients with many places and polymorphous skin defects of hands were treated with combined anterosuperior malleolusdorsalls pedis flaps (6 cases),three-leaf flap of dorsum of foot (2 cases),combined the first dorsal metatarsal artery island flap and toe back flap (5 cases)and combined toe back flaps (5 cases).Meanwhile,deep peroneal nerve was used to repair defect of digital nerve or dorsal digital nerve and long extensor tendon of toes was used to repair digital flexor tendon or digital extensor tendon.Results Eighteen patients with 32 flaps survived.In the follow-up of 4 months-2 years,the fingers and skin flaps were in good shape and normal color.The sensation of the hands of the patients with nerve repaired was restored to S2-S3 and the two-point discrimination was 8-10 mm.The motor function of the hands of the patients with tendons repaired was good,which can be competent to daily life and work.Conclusion Many kinds of combined skin flaps of foot were used to repair many places and polymorphous skin defects of hands.
