CAJ | 학술논문

目的探讨应用上臂内侧游离皮瓣修复手部皮肤缺损的临床效果.方法自2010年4月至2013年3月对10例手部皮肤缺损患者采用上臂内侧皮瓣游离移植修复,行尺侧上副动脉-手部受区动脉、伴行静脉或皮下静脉-手背静脉吻合重建皮瓣血液循环,上臂供区直接缝合闭合创面.结果 10例上臂内侧游离皮瓣全部存活;1例术后出现血管危象,手术探查发现动脉吻合口内有血栓形成,取出血栓后重新吻合血管后皮瓣存活.2例术后3个月行皮瓣整形术.8例患者术后随访2个月至2年,平均11个月,手部皮瓣外观满意,质地好,未见明显萎缩.手指屈伸活动功能恢复良好,屈曲75°～ 90°,伸直-5°～0°.上臂内侧供区创面仅留线性瘢痕.结论上臂内侧游离皮瓣修复手部皮肤缺损是一种较理想的方法.
목적 탐토응용상비내측유리피판수복수부피부결손적림상효과.방법 자2010년4월지2013년3월대10례수부피부결손환자채용상비내측피판유리이식수복,행척측상부동맥-수부수구동맥、반행정맥혹피하정맥-수배정맥문합중건피판혈액순배,상비공구직접봉합폐합창면.결과 10례상비내측유리피판전부존활;1례술후출현혈관위상,수술탐사발현동맥문합구내유혈전형성,취출혈전후중신문합혈관후피판존활.2례술후3개월행피판정형술.8례환자술후수방2개월지2년,평균11개월,수부피판외관만의,질지호,미견명현위축.수지굴신활동공능회복량호,굴곡75°～ 90°,신직-5°～0°.상비내측공구창면부류선성반흔.결론 상비내측유리피판수복수부피부결손시일충교이상적방법.
Objective To evaluate the clinical results of medial upper arm free flap transfer in the treatment of skin defects of the hand.Methods From April 2010 to March 2013,a total of 10 cases of skin defects of the hand were treated with medial upper arm flap transfer.Flap circulation was re-established by anastomosing the superior ulnar collateral artery to the recipient artery of the hand,and the concomitant vein or subcutaneous vein to the dorsal veins of the hand.The donor site wound was directly closed.Results All 10 flaps survived completely.Vascular crisis occurred in 1 case.Surgical exploration revealed a thrombus at the artery anastomosis site.The flap survived after removal of the thrombus and re-anastomosis of the arteries.Two cases underwent flap de-bulking procedures 3 months postoperatively.Eight of the 10 cases had postoperative follow-up ranging from 2 months to 2 years with an average of 11 months.The appearance of the flaps at the hand was satisfactory.Flap texture was good with no obvious atrophy.Range of motion of the fingers recovered well.Finger flexion achieved 75° to 90°while finger extension-5° to 0°.The donor site wound was concealed with only linear scar.Conclusion Medial upper arm free flap transfer is an ideal option for repairing skin defects of the hand.