CAJ | 학술논문

目的：探讨游离尺动脉腕上穿支皮瓣修复手指软组织缺损的方法及临床效果。方法：2010年2月至2012年12月，应用游离尺动脉腕上穿支皮瓣修复手指软组织缺损16例，男10例，女6例；年龄18～52岁，平均38．2岁。热压伤5例，机器挤压伤8例，鞭炮炸伤3例。缺损面积：1．3 cm×2．3 cm～2．6 cm×5．0 cm。皮瓣切取面积：1．5 cm×2．5 cm～2．8 cm×5．2 cm。观察皮瓣外形及两点分辨觉。结果：术后皮瓣全部存活，伤口均Ⅰ期愈合，供受区没有并发伤口感染及皮肤坏死。前臂供区直接缝合11例，游离植皮5例。所有病例获随访，时间6～24个月，平均10．8个月，皮瓣外观不臃肿，质地色泽接近受区，皮瓣感觉恢复良好，两点分辨觉为6～9 mm。供区外形较好，无明显功能障碍，伴轻度瘢痕形成。结论：游离尺动脉腕上穿支皮瓣具有血管解剖恒定、厚薄适中、带感觉神经等优点，是修复手指软组织缺损的有效方法。
목적：탐토유리척동맥완상천지피판수복수지연조직결손적방법급림상효과。방법：2010년2월지2012년12월，응용유리척동맥완상천지피판수복수지연조직결손16례，남10례，녀6례；년령18～52세，평균38．2세。열압상5례，궤기제압상8례，편포작상3례。결손면적：1．3 cm×2．3 cm～2．6 cm×5．0 cm。피판절취면적：1．5 cm×2．5 cm～2．8 cm×5．2 cm。관찰피판외형급량점분변각。결과：술후피판전부존활，상구균Ⅰ기유합，공수구몰유병발상구감염급피부배사。전비공구직접봉합11례，유리식피5례。소유병례획수방，시간6～24개월，평균10．8개월，피판외관불옹종，질지색택접근수구，피판감각회복량호，량점분변각위6～9 mm。공구외형교호，무명현공능장애，반경도반흔형성。결론：유리척동맥완상천지피판구유혈관해부항정、후박괄중、대감각신경등우점，시수복수지연조직결손적유효방법。
Objective:To investigate the methods and clinical effects of repairing finger soft tissue defect with free vascu-larized flaps based on the wrist cutaneous branch of ulnar artery. Methods:From February 2010 to December 2012,16 pa-tients with finger soft tissue defects were repaired by free vascularized flaps based on the wrist cutaneous branch of ulnar artery,including 10 males and 6 females with an average age of 38.2 years old ranging from 18 to 52 years. Among them ,5 cases caused by hot crush injury ,8 cases caused by machine crush injury ,3 cases caused by firecracker burst injury. The de-fect area varied from 1.3 cm×2.3 cm to 2.6 cm×5.0 cm. The flap area varied from 1.5 cm×2.5 cm to 2.8 cm×5.2 cm. The ap-pearance and two point discrimination of flap were observed after operation. Results:All flaps survived and wounds healed pri-marily. No wound infection and skin necrosis were found in donor site and recipient site. Among repair methods ,direct suture in forearm donor site had 11 cases and skin graft had 5 cases. All patients were followed up from 6 to 24 months with an aver-age of 10.8 months. The appearance of flap was not fat or clumsy ,texture and color were similar to the recipient site ,the sensa-tion were good,two point discrimination was 6 to 9 mm. The appearance of donor site were well complicated with mild scarring without dysfunction obviously. Conclusion:The free vascularized flaps based on the wrist cutaneous branch of ulnar artery has the advantages of vascular anatomy constant,thickness moderate and carry sensory nerves,etc,which is effective way to repair finger soft tissue defects.