CAJ | 학술논문

目的探讨游离腹股沟皮瓣修复手部皮肤缺损的临床疗效.方法对9例手部皮肤软组织缺损采用游离腹股沟皮瓣移植修复,切取面积为12.0 cm× 8.0 cm～ 7.5 cm× 6.0 cm.术中修剪皮瓣边缘部分脂肪组织；旋髂浅动脉与桡动脉终末支吻合6例,与指总动脉吻合3例；8例同时修复一根伴行静脉和一根皮下静脉,l例仅修复一根伴行静脉.结果 1例吻合一根伴行静脉的皮瓣,于术后第2天出现静脉危象,经对症处理保守治疗后,皮瓣表皮坏死,皮下软组织成活,二期予植皮术.余8例皮瓣全部顺利存活.随访3个月至1.5年,皮瓣质地软,稍臃肿,感觉恢复至S2～S3,腹部供区瘢痕小.结论利用游离腹股沟皮瓣移植修复手部皮肤软组织缺损,供区能直接缝合,且部位隐蔽,瘢痕小.较常规带蒂皮瓣减少了手术次数,缩短了治疗时间,是修复手部皮肤软组织缺损较好的方法.
목적 탐토유리복고구피판수복수부피부결손적림상료효.방법 대9례수부피부연조직결손채용유리복고구피판이식수복,절취면적위12.0 cm× 8.0 cm～ 7.5 cm× 6.0 cm.술중수전피판변연부분지방조직；선가천동맥여뇨동맥종말지문합6례,여지총동맥문합3례；8례동시수복일근반행정맥화일근피하정맥,l례부수복일근반행정맥.결과 1례문합일근반행정맥적피판,우술후제2천출현정맥위상,경대증처리보수치료후,피판표피배사,피하연조직성활,이기여식피술.여8례피판전부순리존활.수방3개월지1.5년,피판질지연,초옹종,감각회복지S2～S3,복부공구반흔소.결론 이용유리복고구피판이식수복수부피부연조직결손,공구능직접봉합,차부위은폐,반흔소.교상규대체피판감소료수술차수,축단료치료시간,시수복수부피부연조직결손교호적방법.
Objective To discuss the clinical results of the free groin flap in treating skin and soft tissue defect of the hand.Methods The free groin flap was used to treat 9 cases of skin and soft tissues defects of the hand.The size of the flaps ranged from 12.0 cm × 8.0 cm to 7.5 cm × 6.0 cm.The fatty tissue at the edge of the flaps was trimmed before flap transfer.Reperfusion of the flap was established by anastomosing the superficial iliac circumflex artery to the terminal branch of the radial artery in 6 cases and to the common digital artery in 3 cases.Flap drainage was through one concomitant vein and one subcutaneous vein in 8 cases and through only one concomitant vein in 1 case.Results Venous crisis occurred in the case with only one concomitant vein anastomosed 2 days postoperatively.Conservative treatment preserved the subcutaneous tissue of the flap with skin necrosis that needed secondary skin graft.All other 8 flaps survived uneventfully.The patients were follow-up for 3 to 18 months.The flaps were soft with good texture,but slightly bulky.Sensation of the flaps recovered to S2 to S3.The scar at the abdominal donor site was small.Conclusion Free groin flap is a good option for treatment of soft tissue defects of the hand.The donor site is hidden and the scar is small.It has one less operation than pedicled flaps and thus shortens the course of treatment and relieves patient burden.