中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2015年
2期
120-122
,共3页
金秀%王涛%蒋子平%于家傲%路来金
金秀%王濤%蔣子平%于傢傲%路來金
금수%왕도%장자평%우가오%로래금
电烧伤%四肢%外科皮瓣%创面
電燒傷%四肢%外科皮瓣%創麵
전소상%사지%외과피판%창면
Electrical bums%Limbs%Surgical flap%Wounds
目的 探讨四肢电烧伤创面皮瓣修复的修复方法和手术适应证. 方法 1997年5月-2014年6月,共收治四肢电烧伤后软组织缺损患者38例,分别于电烧伤后7～14d内采用了皮瓣修复,其中局部旋转皮瓣4例,鱼际皮瓣1例,示指背侧皮瓣2例,交腿皮瓣1例,足底内侧皮瓣1例,带蒂背阔肌皮瓣2例,前臂骨间后动脉逆行岛状皮瓣4例,掌背动脉逆行岛状皮瓣4例,髂腹股沟皮瓣10例;游离桡动脉皮瓣1例,游离背阔肌皮瓣1例,游离股前外侧皮瓣3例;前臂后侧骨间前动脉穿支逆行岛状皮瓣1例,小腿后侧穿支逆行岛状皮瓣2例,小腿前外侧穿支逆行岛状皮瓣1例.皮瓣切取范围42.0 cm×13.0 cm～6.0 cm×3.0 cm.结果 术后随访时间4～42个月,平均6、7个月.皮瓣完全成活35例,占92.1％;尖端部分坏死3例,占7.9％.坏死部分经局部换药均在术后1个月内自行愈合.肢体和手的外形较为满意,手腕部电烧伤病例28例,功能优和良共15例,占57.1％;中8例,占28.6％;差5例,占14.3％. 结论 对电烧伤创面进行早期皮瓣修复,是保护肢体深部组织结构、预防控制继发感染、最大限度保留肢体功能的有效方法.
目的 探討四肢電燒傷創麵皮瓣脩複的脩複方法和手術適應證. 方法 1997年5月-2014年6月,共收治四肢電燒傷後軟組織缺損患者38例,分彆于電燒傷後7～14d內採用瞭皮瓣脩複,其中跼部鏇轉皮瓣4例,魚際皮瓣1例,示指揹側皮瓣2例,交腿皮瓣1例,足底內側皮瓣1例,帶蒂揹闊肌皮瓣2例,前臂骨間後動脈逆行島狀皮瓣4例,掌揹動脈逆行島狀皮瓣4例,髂腹股溝皮瓣10例;遊離橈動脈皮瓣1例,遊離揹闊肌皮瓣1例,遊離股前外側皮瓣3例;前臂後側骨間前動脈穿支逆行島狀皮瓣1例,小腿後側穿支逆行島狀皮瓣2例,小腿前外側穿支逆行島狀皮瓣1例.皮瓣切取範圍42.0 cm×13.0 cm～6.0 cm×3.0 cm.結果 術後隨訪時間4～42箇月,平均6、7箇月.皮瓣完全成活35例,佔92.1％;尖耑部分壞死3例,佔7.9％.壞死部分經跼部換藥均在術後1箇月內自行愈閤.肢體和手的外形較為滿意,手腕部電燒傷病例28例,功能優和良共15例,佔57.1％;中8例,佔28.6％;差5例,佔14.3％. 結論 對電燒傷創麵進行早期皮瓣脩複,是保護肢體深部組織結構、預防控製繼髮感染、最大限度保留肢體功能的有效方法.
목적 탐토사지전소상창면피판수복적수복방법화수술괄응증. 방법 1997년5월-2014년6월,공수치사지전소상후연조직결손환자38례,분별우전소상후7～14d내채용료피판수복,기중국부선전피판4례,어제피판1례,시지배측피판2례,교퇴피판1례,족저내측피판1례,대체배활기피판2례,전비골간후동맥역행도상피판4례,장배동맥역행도상피판4례,가복고구피판10례;유리뇨동맥피판1례,유리배활기피판1례,유리고전외측피판3례;전비후측골간전동맥천지역행도상피판1례,소퇴후측천지역행도상피판2례,소퇴전외측천지역행도상피판1례.피판절취범위42.0 cm×13.0 cm～6.0 cm×3.0 cm.결과 술후수방시간4～42개월,평균6、7개월.피판완전성활35례,점92.1％;첨단부분배사3례,점7.9％.배사부분경국부환약균재술후1개월내자행유합.지체화수적외형교위만의,수완부전소상병례28례,공능우화량공15례,점57.1％;중8례,점28.6％;차5례,점14.3％. 결론 대전소상창면진행조기피판수복,시보호지체심부조직결구、예방공제계발감염、최대한도보류지체공능적유효방법.
Objective To investigate the surgical indications and repair methods for the treatment of electrical bums in the limbs.Methods Thirty-eight cases since May,1997 to June,2014 who underwent flap treatment in 7-14 days after electrical bums was summarized.Among these patients,4 cases were treated by local flaps,1 case was treated by thenar flap,2 cases were treated by dorsal island skin flap of the index finger,1 case was treated by cross-leg flap,1 case was treated by medial plantar skin flap;2 cases were treated by pedicle latissimus dorsi flaps,4 cases were treated by antebrachial flap with a pedicle of the posterior interosseous artery,4 cases were treated by metacarpal artery reversed island flaps,10 cases were treated by groin flaps;1 case was treated by free radial artery flap,1 case was treated by free latissimus dorsi flap,3 cases were treated by free anterolateral thigh flaps;1 case was treated by reverse island forearm posterior interosseous flap,2 cases were treated by posterior perforator reversed island flaps of the lower leg,1 case was treated by anterolateral perforator reversed island flaps of the lower leg.The area of flap was from 42.0 cm × 13.0 cm to 6.0 cm × 3.0 cm.The survival rate of the flap,the appearance and function of limb were observed.Results All these patients were followed up from 4 months to 3 years 6 months,the mean time was 6 months and 20 days.Thirty-five flaps survived completely,accounting for 92.1％,and 3 cases suffered partial necrosis at the distal end,accounting for 7.9％.Secondary healing was achieved by dress changing.The appearance of the limbs was satisfactory.Among the 28 cases whose bums were on the hands,the total number of excellent and good was 15,medium was 8,and 5 poor cases.The excellent and good rate was 57.1％.Conclusion Early repairing of the electrical burns with flaps is the effective method for protecting the deep structures of the limb,preventing and control the secondary infections and preserve the function of the limbs.
