中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2012年
6期
450-452,后插3
,共4页
徐永清%朱跃良%范新宇%石骥%梅良斌%李军%唐辉%李川
徐永清%硃躍良%範新宇%石驥%梅良斌%李軍%唐輝%李川
서영청%주약량%범신우%석기%매량빈%리군%당휘%리천
小腿%穿支皮瓣%移植%创伤%显微外科手术
小腿%穿支皮瓣%移植%創傷%顯微外科手術
소퇴%천지피판%이식%창상%현미외과수술
Leg%Perforator flaps%Transfer%Trauma%Microsurgical operation
目的 观察便携式超声仪定位小腿穿支皮瓣血管的效果,以及小腿穿支皮瓣修复四肢创面的效果.方法 自2009年12月至2011年3月,应用便携式超声仪检测定位穿支皮瓣血管,应用吻合血管的小腿穿支皮瓣修复四肢创面31例,其中吻合血管的腓动脉穿支皮瓣24例(其中4例含腓动脉穿支骨瓣),胫后动脉穿支皮瓣3例,腓肠内侧动脉穿支皮瓣2例,腓肠外侧穿支皮瓣2例;切取皮瓣面积最大15.0 cm×8.0 cm,最小1.0 cm×1.5 cm,穿支皮瓣的口径最小0.2 mm,最大1.8 mm;修复部位:手指及虎口创面21例,前臂创面5例,小腿创面5例.结果 超声定位术中符合率为96.8％.31例皮瓣全部成活,创面修复,供区创面小的直接缝合愈合,供区创面较大的植皮修复愈合.结论 便携式超声仪定位小腿穿支皮瓣血管准确、可靠,小腿穿支皮瓣切取方便,厚度满意,供区创伤小,成活率高.
目的 觀察便攜式超聲儀定位小腿穿支皮瓣血管的效果,以及小腿穿支皮瓣脩複四肢創麵的效果.方法 自2009年12月至2011年3月,應用便攜式超聲儀檢測定位穿支皮瓣血管,應用吻閤血管的小腿穿支皮瓣脩複四肢創麵31例,其中吻閤血管的腓動脈穿支皮瓣24例(其中4例含腓動脈穿支骨瓣),脛後動脈穿支皮瓣3例,腓腸內側動脈穿支皮瓣2例,腓腸外側穿支皮瓣2例;切取皮瓣麵積最大15.0 cm×8.0 cm,最小1.0 cm×1.5 cm,穿支皮瓣的口徑最小0.2 mm,最大1.8 mm;脩複部位:手指及虎口創麵21例,前臂創麵5例,小腿創麵5例.結果 超聲定位術中符閤率為96.8％.31例皮瓣全部成活,創麵脩複,供區創麵小的直接縫閤愈閤,供區創麵較大的植皮脩複愈閤.結論 便攜式超聲儀定位小腿穿支皮瓣血管準確、可靠,小腿穿支皮瓣切取方便,厚度滿意,供區創傷小,成活率高.
목적 관찰편휴식초성의정위소퇴천지피판혈관적효과,이급소퇴천지피판수복사지창면적효과.방법 자2009년12월지2011년3월,응용편휴식초성의검측정위천지피판혈관,응용문합혈관적소퇴천지피판수복사지창면31례,기중문합혈관적비동맥천지피판24례(기중4례함비동맥천지골판),경후동맥천지피판3례,비장내측동맥천지피판2례,비장외측천지피판2례;절취피판면적최대15.0 cm×8.0 cm,최소1.0 cm×1.5 cm,천지피판적구경최소0.2 mm,최대1.8 mm;수복부위:수지급호구창면21례,전비창면5례,소퇴창면5례.결과 초성정위술중부합솔위96.8％.31례피판전부성활,창면수복,공구창면소적직접봉합유합,공구창면교대적식피수복유합.결론 편휴식초성의정위소퇴천지피판혈관준학、가고,소퇴천지피판절취방편,후도만의,공구창상소,성활솔고.
Objective To evaluate the locating effects of a portable ultrasound for leg perforator flaps,and the clinical effects of leg perforator flaps for the wounds of the extremities.Methods Since December 2009 to March 2011,thirty-one cases of soft tissue defects of the extremities were treated with free vascularized leg perforator flaps in our center.A portable ultrasound were used for the locating of the perforator arteries of the leg before the operations.These flaps include 24 cases of the fibular artery perforator flaps (4 with simultaneous fibula transfer),three cases of the posterior tibia artery perforator flap,two cases of the medial gastrocnemius artery perforator flap,and 2 cases of the lateral gastrocnemius artery perforator flap.The flap size ranged from 15.0 cm × 8.0 cm to 1.0 cm × 1.5 cm.The caliber diameter of the perforator artery ranged from 0.2 mm to 1.8 mm.The wounds included 21 cases of the hand,five cases of the forearm,and 5 cases of the leg.Results The coincidence rate intraoperatively of the portable ultrasound was 96.8％.All the flaps survived and the wounds healed uneventfully.The donor site of the flaps were either closed directly or closed with partial split-thickness skin graft.Conclusion The portable ultrasound is an effective,reliable and accurate instrument for locating the leg perforator flaps.The leg perforator flaps have the advantages of convenient harvest,satisfactory thickness,less donor site morbidity,and high survival rate.
