CAJ | 학술논문

目的：探讨手、足部软组织缺损的最适宜临床修复方法。方法2008年8月～2014年12月，对23例手背部、手掌部或足背皮肤软组织严重缺损患者采用超薄股前外侧穿支游离皮瓣移植修复，皮肤缺损面积为10 cm ×5 cm～20 cm ×9 cm之间，术中修剪皮瓣边缘部分脂肪组织。术后对皮瓣外形满意度，质地、弹性和痛觉、触觉、温度觉、两点分辨觉等感觉功能进行评估。结果本组病例皮瓣未发生血管危象，移植皮瓣全部成活。有11例获得6～12个月的随访，皮瓣外形、质地、弹性良好。术后12个月皮瓣两点分辨觉平均为（4～5）mm、感觉评级为（S3＋）。结论适度修薄股前外侧穿支皮瓣是修复手部严重软组织缺损的一种较安全有效的方法。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的最适宜方法。
목적：탐토수、족부연조직결손적최괄의림상수복방법。방법2008년8월～2014년12월，대23례수배부、수장부혹족배피부연조직엄중결손환자채용초박고전외측천지유리피판이식수복，피부결손면적위10 cm ×5 cm～20 cm ×9 cm지간，술중수전피판변연부분지방조직。술후대피판외형만의도，질지、탄성화통각、촉각、온도각、량점분변각등감각공능진행평고。결과본조병례피판미발생혈관위상，이식피판전부성활。유11례획득6～12개월적수방，피판외형、질지、탄성량호。술후12개월피판량점분변각평균위（4～5）mm、감각평급위（S3＋）。결론괄도수박고전외측천지피판시수복수부엄중연조직결손적일충교안전유효적방법。교상규대체피판감소료수술차수，축단료치료시간，시수복수부피부연조직결손적최괄의방법。
Objective To discuss clinical results of treating soft tissues defect of hand and foot .Methods Twenty-three patients were treated with ultrathin anterolateral femoral flap transplant for their severe subcutaneous tissue defects on hand or foot with a skin defect area between 10cm*5cm and 20cm*9cm from August, 2008 to De-cember, 2014.Fat tissue was trimmed off the flap during the surgery .An evaluation was done on patients'satisfactory level of the flap's appearance, texture, elasticity and sensory functions like sense of pain , touch, temperature, and two-point distinguishing .Results Vascular crisis was not observed on any patient and the transplanted flaps all survived.A 6-12 month follow-up was done in 11 cases about the flap's appearance , texture and elasticity , and the results were all satisfactory .The average value of sense of two points distinguishing 12 months after the surgery was (4-5) mm, and the sensory rate was (S3+).Conclusion Transplantation of appropriate thickness anterolateral femoral flap to repair severe hand defect is a safe and effective method , which requires less operations than transplan-tation of pedicle flap and in turn shortens treatment time .