CAJ | 학술논문

目的：探讨基于三维重建技术的旋股外动脉降支侧支皮瓣修复四肢软组织缺损的临床效果。方法观察2010年6月-2014年1月收治的100例四肢软组织缺损患者，按年龄分组，入院后对合并伤进行对症处理后行皮肤移植术，术中用手术刀取6.5 cm ×9.5cm到13cm ×16.5cm大小的旋股外动脉降支侧支游离皮瓣移植于缺损处，观察皮肤移植术成功率及术后创面的愈合情况。并分析各个年龄段的移植成功率。结果旋股外动脉降支侧支游离皮瓣在皮瓣缺损修复中效果显著，成功率98％。术后皮瓣完全成活，缺损区及皮瓣供区创口全部I期愈合。患者均获得随访，随访时间4～8个月。皮瓣外形质量均好，患者皮瓣提供区无明显畸形和功能障碍，感觉恢复较好，能满足日常生活需要。肘，掌指，跖趾关节，膝关节等功能满意，能正常活动。供区无明显瘢痕形成，肢体无异常。结果显示不同性别之间，移植成功率无明显差异。年龄越小，皮瓣移植成功率相对较高。结论旋股外动脉降支侧支皮瓣血供好，操作简单，对皮瓣提供区影响较小，术前三维重建设计可明显提高手术成功率，是修复皮肤、肌肉组织缺损的首选皮瓣。
목적：탐토기우삼유중건기술적선고외동맥강지측지피판수복사지연조직결손적림상효과。방법관찰2010년6월-2014년1월수치적100례사지연조직결손환자，안년령분조，입원후대합병상진행대증처리후행피부이식술，술중용수술도취6.5 cm ×9.5cm도13cm ×16.5cm대소적선고외동맥강지측지유리피판이식우결손처，관찰피부이식술성공솔급술후창면적유합정황。병분석각개년령단적이식성공솔。결과선고외동맥강지측지유리피판재피판결손수복중효과현저，성공솔98％。술후피판완전성활，결손구급피판공구창구전부I기유합。환자균획득수방，수방시간4～8개월。피판외형질량균호，환자피판제공구무명현기형화공능장애，감각회복교호，능만족일상생활수요。주，장지，척지관절，슬관절등공능만의，능정상활동。공구무명현반흔형성，지체무이상。결과현시불동성별지간，이식성공솔무명현차이。년령월소，피판이식성공솔상대교고。결론선고외동맥강지측지피판혈공호，조작간단，대피판제공구영향교소，술전삼유중건설계가명현제고수술성공솔，시수복피부、기육조직결손적수선피판。
Objective To investigate the clinical effect of femoral circumflex artery LAD collateral flap for re-pairing soft tissue defects of limb reduction of 3D reconstruction based on the lateral femoral circumflex artery .Method From June 2010 to Jan.2014, 100 cases of soft tissue defects of extremities were observed .Groups were divided according to ages, genders.After symptomatic treatment of associated injuries , the skin graft surgery underwent , and a scalpel was used in the surgery to take 6.5 cm ×9.5 cm to 13cm ×16.5cm size descending branch of lateral femoral circumflex ar-tery collateral free flap in the defects .Then the success rate of skin grafting and postoperative wound healing were ob-served.Result Femoral circumflex artery LAD collateral free flap defect repairing was in a significant effect with the suc -cess rate of 98%.All the flaps survived , and the incision at donor site wounds were healed I .The patients were followed up for 4-8 months.The appearance and the quality of the flaps were all good .Skin donor site deformity and of patients dysfunction were not obvious , and the restoration of protective sensation were recovered well , which could meet the needs of daily life.Elbow, metacarpophalangeal joint and knee joint all had satisfied functions and normal activities , which could meet the daily-life needs.There were no obvious scar formations in the area , which also had no limb abnormalities .The results showed that among different genders , transplant success rate was no significant difference .The results showed that the younger the patient was , the higher the success rate was relatively .Conclusion Femoral circumflex artery flap de-scending artery collateral blood supply was good , and the operation was simple .In addition , there was little influence on the donor area.Preoperative 3D reconstruction design could improve the success rate of operation , and it could be used as one of the preferring flap for repairing of soft tissue defects .