中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2013年
4期
212-214
,共3页
外科皮瓣%指损伤%软组织损伤%穿支皮瓣
外科皮瓣%指損傷%軟組織損傷%穿支皮瓣
외과피판%지손상%연조직손상%천지피판
Surgical flaps%Finger injuries%Soft tissue injuries%Perforator flap
目的 探讨掌背动脉穿支蒂逆行筋膜皮瓣与蒂部设计微型瓣的方法及其临床疗效.方法 2006年10月至2011年8月,对17例手指皮肤软组织缺损伴指骨或肌腱外露患者,采用掌背动脉穿支蒂逆行筋膜皮瓣进行修复,皮瓣切取面积为7.5 cm× 3.0 cm～4.0cm×2.0 cm.术中在掌背动脉穿支蒂逆行筋膜皮瓣蒂部设计微型瓣,微型瓣呈圆形或椭圆形,面积为2.0 cm× 1.5 cm～1.0 cm× 1.0 cm.结果 术后16例皮瓣全部存活；1例第2掌背动脉皮瓣出现远端边缘坏死,经换药后愈合.随访时间为6～28个月,平均14.6个月.皮瓣质地柔软,外形良好.皮瓣两点分辨觉为5～9mm,平均7.6mm.手指功能恢复良好.结论 在掌背动脉穿支蒂逆行筋膜皮瓣蒂部设计应用微型瓣可有效地防止蒂部血管受压或血管网破坏而影响皮瓣的血运,是一种预防掌背动脉皮瓣术后血供障碍的可靠方法.
目的 探討掌揹動脈穿支蒂逆行觔膜皮瓣與蒂部設計微型瓣的方法及其臨床療效.方法 2006年10月至2011年8月,對17例手指皮膚軟組織缺損伴指骨或肌腱外露患者,採用掌揹動脈穿支蒂逆行觔膜皮瓣進行脩複,皮瓣切取麵積為7.5 cm× 3.0 cm～4.0cm×2.0 cm.術中在掌揹動脈穿支蒂逆行觔膜皮瓣蒂部設計微型瓣,微型瓣呈圓形或橢圓形,麵積為2.0 cm× 1.5 cm～1.0 cm× 1.0 cm.結果 術後16例皮瓣全部存活；1例第2掌揹動脈皮瓣齣現遠耑邊緣壞死,經換藥後愈閤.隨訪時間為6～28箇月,平均14.6箇月.皮瓣質地柔軟,外形良好.皮瓣兩點分辨覺為5～9mm,平均7.6mm.手指功能恢複良好.結論 在掌揹動脈穿支蒂逆行觔膜皮瓣蒂部設計應用微型瓣可有效地防止蒂部血管受壓或血管網破壞而影響皮瓣的血運,是一種預防掌揹動脈皮瓣術後血供障礙的可靠方法.
목적 탐토장배동맥천지체역행근막피판여체부설계미형판적방법급기림상료효.방법 2006년10월지2011년8월,대17례수지피부연조직결손반지골혹기건외로환자,채용장배동맥천지체역행근막피판진행수복,피판절취면적위7.5 cm× 3.0 cm～4.0cm×2.0 cm.술중재장배동맥천지체역행근막피판체부설계미형판,미형판정원형혹타원형,면적위2.0 cm× 1.5 cm～1.0 cm× 1.0 cm.결과 술후16례피판전부존활；1례제2장배동맥피판출현원단변연배사,경환약후유합.수방시간위6～28개월,평균14.6개월.피판질지유연,외형량호.피판량점분변각위5～9mm,평균7.6mm.수지공능회복량호.결론 재장배동맥천지체역행근막피판체부설계응용미형판가유효지방지체부혈관수압혹혈관망파배이영향피판적혈운,시일충예방장배동맥피판술후혈공장애적가고방법.
Objective To explore the feasibility of designing and applying a mini-flap at the pedicle of dorsal metacarpal perforator fasciocutaneous flap and evaluate the clinical results.Methods From October 2006 to August 2011,17 patients with soft tissue defects of the finger accompanied with exposure of the phalanx or tendons were treated using dorsal metacarpal perforator reversed fasciocutaneous flaps.The size of the flaps ranged from 7.5 cm × 3.0 cm to 4.0 cm × 2.0 cm.A mini-flap,oval or round,was designed at the pedicle of the dorsal metacarpal artery perforator flap.The area of the mini-flap was between 2.0 cm × 1.5 cm to 1.0 cm × 1.0 cm.Results Complete flap survival was seen in 16 cases.Distal marginal flap necrosis occurred in one case which healed after changing the dressing.The mean follow-up time was 14.6 months (range,6 to 28 months).The flaps were supple with good appearance.Two-point discrimination of the flaps ranged from 5 to 9 mm,with an average of 7.6 mm.There was good recovery of finger function.Conclusion A mini-flap designed at the pedicle of the dorsal metacarpal artery perforator fasciocutaneous flap can effectively prevent vessel compressing at the pedicle or vascular network compromise.It is a reliable method to prevent postoperative blood supply problems in dorsal metacarpal artery fasciocutaneous flap transfers.
