中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2013年
3期
157-158
,共2页
费剑荣%杨科跃%孙涛%李学渊%陈宏%章伟文
費劍榮%楊科躍%孫濤%李學淵%陳宏%章偉文
비검영%양과약%손도%리학연%진굉%장위문
外科皮瓣%指损伤%大鱼际
外科皮瓣%指損傷%大魚際
외과피판%지손상%대어제
Surgical flaps%Finger injuries%Thenar
目的 探讨应用游离大鱼际皮瓣修复指腹软组织缺损的方法和临床效果.方法 对2009年9月至2011年1月收治的13例指腹软组织缺损,应用游离大鱼际皮瓣修复.以桡动脉掌浅支及其构成的血管网为血管蒂重建供血,以正中神经掌皮支或桡神经浅支重建皮瓣感觉.皮瓣切取面积为4.7 cm× 3.0 cm~ 2.0 cm× 2.0 cm.结果 术后2例皮瓣出现血管危象,经对症处理后存活;余11例皮瓣顺利存活.13例均获得随访,时间为3~ 12个月,平均4个月.仅1例皮瓣略显臃肿,经再次整形后臃肿消失;其余皮瓣外观及弹性良好,感觉恢复至S3~S4.结论 以桡动脉掌浅支及其构成的血管网为血管蒂的大鱼际皮瓣,其血管解剖表浅、皮肤穿支丰富、感觉重建满意,是修复指腹中小面积缺损的有效方法.
目的 探討應用遊離大魚際皮瓣脩複指腹軟組織缺損的方法和臨床效果.方法 對2009年9月至2011年1月收治的13例指腹軟組織缺損,應用遊離大魚際皮瓣脩複.以橈動脈掌淺支及其構成的血管網為血管蒂重建供血,以正中神經掌皮支或橈神經淺支重建皮瓣感覺.皮瓣切取麵積為4.7 cm× 3.0 cm~ 2.0 cm× 2.0 cm.結果 術後2例皮瓣齣現血管危象,經對癥處理後存活;餘11例皮瓣順利存活.13例均穫得隨訪,時間為3~ 12箇月,平均4箇月.僅1例皮瓣略顯臃腫,經再次整形後臃腫消失;其餘皮瓣外觀及彈性良好,感覺恢複至S3~S4.結論 以橈動脈掌淺支及其構成的血管網為血管蒂的大魚際皮瓣,其血管解剖錶淺、皮膚穿支豐富、感覺重建滿意,是脩複指腹中小麵積缺損的有效方法.
목적 탐토응용유리대어제피판수복지복연조직결손적방법화림상효과.방법 대2009년9월지2011년1월수치적13례지복연조직결손,응용유리대어제피판수복.이뇨동맥장천지급기구성적혈관망위혈관체중건공혈,이정중신경장피지혹뇨신경천지중건피판감각.피판절취면적위4.7 cm× 3.0 cm~ 2.0 cm× 2.0 cm.결과 술후2례피판출현혈관위상,경대증처리후존활;여11례피판순리존활.13례균획득수방,시간위3~ 12개월,평균4개월.부1례피판략현옹종,경재차정형후옹종소실;기여피판외관급탄성량호,감각회복지S3~S4.결론 이뇨동맥장천지급기구성적혈관망위혈관체적대어제피판,기혈관해부표천、피부천지봉부、감각중건만의,시수복지복중소면적결손적유효방법.
Objective To introduce the surgical technique of applying free thenar perforator flap to repair soft tissue defects of the pulp and evaluate the clinical outcome.Methods From September 2009 to January 2011,13 cases of soft tissue defect of the pulp were treated with free thenar perforator flap.The size of the harvested flaps was between 4.7 cm × 3.0 cm to 2.0 cm × 2.0 cm.The flap was perfused by superficial palmar branch of the radial artery and its vascular network,while sensation of the flap was reconstructed via median nerve cutaneous branch or radial nerve superficial branch.According to caliber of the artery,blood vessels were anastomosed either in an end-to-end or end-to-side fashion.Results Vascular crisis occurred in 2 cases postoperatively,which were rescued by proper treatment.The other 11 transferred free flaps survived uneventfully.All cases were follow-up for 3 to 12 months.The appearance as well as texture of the flaps was satisfactory,except in one case the flap was bulky that required secondary debulking surgery.Sensation of the pulps recovered to S3 to S4.Conclusion The thenar flap based on superficial palmar branch of the radial artery and its vascular network is a good option to repair soft tissue defects of the pulp.It has superficial vascular pedicle which is easy to dissect,has abundant perforators,and has sensory nerve branched for sensory reconstruction.