CAJ | 학술논문

目的比较真皮下血管网皮瓣在不同时间断蒂临床疗效的差异.方法回顾性分析2003年至2010年,采用髂腹股沟真皮下血管网皮瓣修复手部创面96例,随访时间均在6个月以上,按皮瓣断蒂时间分为四组,其中2～3周31例(A组),大于3周25例(B组),大于4周19例(C组),大于5周21例(D组).术后对皮瓣成活率、伤口感染率、肩关节功能恢复、手功能恢复、皮瓣质地、恢复伤前活动的时间等指标进行评价.结果术后四组皮瓣全部存活,皮瓣质地与手功能恢复各组比较差异均无统计学意义(P＞0.05),A组患者肩关节功能恢复时间短、伤口感染率低及恢复伤前活动时间短,与其他三组比较差异有统计学意义(P＜0.05).结论真皮下血管网皮瓣在术后2～3周断蒂存活良好,合并症少,临床疗效满意.
목적 비교진피하혈관망피판재불동시간단체림상료효적차이.방법 회고성분석2003년지2010년,채용가복고구진피하혈관망피판수복수부창면96례,수방시간균재6개월이상,안피판단체시간분위사조,기중2～3주31례(A조),대우3주25례(B조),대우4주19례(C조),대우5주21례(D조).술후대피판성활솔、상구감염솔、견관절공능회복、수공능회복、피판질지、회복상전활동적시간등지표진행평개.결과 술후사조피판전부존활,피판질지여수공능회복각조비교차이균무통계학의의(P＞0.05),A조환자견관절공능회복시간단、상구감염솔저급회복상전활동시간단,여기타삼조비교차이유통계학의의(P＜0.05).결론 진피하혈관망피판재술후2～3주단체존활량호,합병증소,림상료효만의.
Objective To compare the clinical results of the subdermal vascular network skin flaps that had different pedicle division time.Methods A retrospective review was conducted of the 96 cases of hand wounds treated with the ilioinguinal subdermal vascular network skin flap from 2003 to 2010.All the cases were follow-up for more than 6 months.They were divided into 4 groups according to the time interval between flap transfer and pedicle division:the pedicle division time of 31 patients was 2 to 3 weeks (group A),that of 25 patients was more than 3 weeks (group B),that of 19 patients was more than 4 weeks (group C),and that of 21 patients was more than 5 weeks (group D).The flap survival rate,wound infection rate,recovery of shoulder function,recovery of hand function,flap quality and the return to pre-injury activity time were used to evaluate the clinical outcomes.Results All flaps of the 4 groups survived.There were no statistically significant differences (P ＞ 0.05) for the skin quality and recovery of hand function.For patients in group A,their shoulder joint function recovered the best,wound infection rate was the lowest,and recovery time to pre-injury activities was the shortest.In these three respects,compared with the other 3 groups,the differences were statistically significant (P ＜ 0.05) for group A.Conclusion When the pedicle is divided 2 to 3 weeks after flap surgery,the subdermal vascular network skin flap survived well,with fewer complications and better clinical efficacy.