中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2014年
5期
424-427
,共4页
李修权%孙广峰%王达利%魏在荣%祁建平%聂开瑜%金文虎%邓呈亮%李海
李脩權%孫廣峰%王達利%魏在榮%祁建平%聶開瑜%金文虎%鄧呈亮%李海
리수권%손엄봉%왕체리%위재영%기건평%섭개유%금문호%산정량%리해
腕%外科皮瓣%逆行骨间后动脉%创面修复
腕%外科皮瓣%逆行骨間後動脈%創麵脩複
완%외과피판%역행골간후동맥%창면수복
Wrist%Surgical flaps%Reverse posterior interosseous artery%Wound repair
目的 探讨逆行骨间后动脉双叶穿支皮瓣修复腕部皮肤软组织缺损的疗效 方法 2010年12 月-2012年3月,笔者单位收治7例腕部皮肤软组织缺损的患者,其中单纯皮肤软组织缺损4例、皮肤软组织缺损合并桡侧肌腱缺损3例,腕掌侧皮肤缺损面积为4.8 cm ×4.0 cm～6.2 cm×4.5 cm,腕背侧皮肤缺损面积为3.5 cm×3.2c m～6.5 cm ×5.4 cm 腕部创面缺损原因:交通伤3例、机器绞伤2例、烧伤1例、肿瘤切除术后1例 采用逆行骨间后动脉双叶穿支皮瓣修复创面,一叶皮瓣大小为2.5cm ×2.0 cm～3.5cm×2.5 cm,另一叶皮瓣大小为2.5cm×2.5cm～4.0cm×3.0cm,皮瓣供 区直接拉拢缝合 . 结果 术后皮瓣均完全成活 随访6～36个月,患者皮瓣色泽、质地、外形良好,末次随访时皮瓣两点辨别觉距离为9～ 13 mm,腕关节背伸、掌屈功能恢复较佳,根据中华医学会手外科学会上肢部分功能评定试用标准,患者腕部功能评定结果为优6例、良1例. 供区遗留一线形瘢痕 . 结论 逆行骨间后动脉双叶穿支皮瓣修复腕部皮肤软组织缺损具有设计灵活、切取方便、供区损伤小、血供可靠等优点,是修复该类创面的义一选择.
目的 探討逆行骨間後動脈雙葉穿支皮瓣脩複腕部皮膚軟組織缺損的療效 方法 2010年12 月-2012年3月,筆者單位收治7例腕部皮膚軟組織缺損的患者,其中單純皮膚軟組織缺損4例、皮膚軟組織缺損閤併橈側肌腱缺損3例,腕掌側皮膚缺損麵積為4.8 cm ×4.0 cm～6.2 cm×4.5 cm,腕揹側皮膚缺損麵積為3.5 cm×3.2c m～6.5 cm ×5.4 cm 腕部創麵缺損原因:交通傷3例、機器絞傷2例、燒傷1例、腫瘤切除術後1例 採用逆行骨間後動脈雙葉穿支皮瓣脩複創麵,一葉皮瓣大小為2.5cm ×2.0 cm～3.5cm×2.5 cm,另一葉皮瓣大小為2.5cm×2.5cm～4.0cm×3.0cm,皮瓣供 區直接拉攏縫閤 . 結果 術後皮瓣均完全成活 隨訪6～36箇月,患者皮瓣色澤、質地、外形良好,末次隨訪時皮瓣兩點辨彆覺距離為9～ 13 mm,腕關節揹伸、掌屈功能恢複較佳,根據中華醫學會手外科學會上肢部分功能評定試用標準,患者腕部功能評定結果為優6例、良1例. 供區遺留一線形瘢痕 . 結論 逆行骨間後動脈雙葉穿支皮瓣脩複腕部皮膚軟組織缺損具有設計靈活、切取方便、供區損傷小、血供可靠等優點,是脩複該類創麵的義一選擇.
목적 탐토역행골간후동맥쌍협천지피판수복완부피부연조직결손적료효 방법 2010년12 월-2012년3월,필자단위수치7례완부피부연조직결손적환자,기중단순피부연조직결손4례、피부연조직결손합병뇨측기건결손3례,완장측피부결손면적위4.8 cm ×4.0 cm～6.2 cm×4.5 cm,완배측피부결손면적위3.5 cm×3.2c m～6.5 cm ×5.4 cm 완부창면결손원인:교통상3례、궤기교상2례、소상1례、종류절제술후1례 채용역행골간후동맥쌍협천지피판수복창면,일협피판대소위2.5cm ×2.0 cm～3.5cm×2.5 cm,령일협피판대소위2.5cm×2.5cm～4.0cm×3.0cm,피판공 구직접랍롱봉합 . 결과 술후피판균완전성활 수방6～36개월,환자피판색택、질지、외형량호,말차수방시피판량점변별각거리위9～ 13 mm,완관절배신、장굴공능회복교가,근거중화의학회수외과학회상지부분공능평정시용표준,환자완부공능평정결과위우6례、량1례. 공구유류일선형반흔 . 결론 역행골간후동맥쌍협천지피판수복완부피부연조직결손구유설계령활、절취방편、공구손상소、혈공가고등우점,시수복해류창면적의일선택.
Objective To explore the curative effect of reverse bi-pedicle posterior interosseous artery perforator flap in repairing skin and soft tissue defects on the wrist.Methods Seven patients with soft tissue defects on the wrist,including simple skin and sott tissue defects in 4 cases and skin and soft tissue defects combined with radial tendon injury in 3 cases,were hospitalized from December 2010 to March2012.The areaofskin defect on the volar sideofthe wrist ranged from 4.8 cm×4.0 cm to6.2 cm ×4.5 cm,while that on the dorsal side ranged from 3.5 cm × 3.2 cm to 6.5 cm × 5.4 cm.These wounds were respectively caused by traffic injury (3 cases),reamer injury (2 cases),burn (1 case),and tumor resection (1 case).Reverse bi-pedicle posterior interosseous artery perforator flaps were used to repair these defects,with area of one pedicle ranging from 2.5 cm × 2.0 cm to 3.5 cm × 2.5 cm and the area of the other pedicle ranging from 2.5 cm × 2.5 cm to 4.0 cm × 3.0 cm.The donor sites were closed by suturing.Results All flaps survived completely.Patients were followed up for 6 to 36 months.The color,texture,and appearance of all flaps were satisfactory.At last follow-up,distances of two-point discrimination of flaps ranged from 9 to 13 mm.The dorsal extension and palmar flexion functions of wrist were satisfactory.The resuhs of function evaluation of 7 wrists were excellent in 6 cases and good in 1 case according to the tentative standards for the evaluation of upper extremity function of Society of Hand Surgery of Chinese Medical Association.A linear scar was formed at the donor site.Conclusions The reverse bi-pedicle posterior interosseous artery perforator flap,with advantages of flexible design,easy to achieve,less injury to donor site,and reliable blood supply,etc.,is another choice for repairing skin and soft tissue defects over the wrist.
