摘要
目的 探讨应用游离腓动脉穿支皮瓣修复手部皮肤软组织缺损的临床疗效.方法 2012年6月-2015年12月,应用游离腓动脉穿支皮瓣修复手部皮肤软组织缺损17例.缺损面积：2.0 cm×3.5 cm-9.0 cm×10.0 cm,分别采用面积为2.5 cm×4.0 cm-10.0 cm×11.0 cm的游离腓动脉穿支皮瓣移植修复.供区创面直径3.0 cm以内直接拉拢缝合,其余以全厚皮片植皮修复.结果 术后17例皮瓣顺利成活,伤口Ⅰ期愈合,1例皮瓣边缘部分坏死,经换药后愈合.供区切口愈合良好,皮片全部成活.术后随访3-16个月,平均6.2个月.皮瓣外形好,质地柔软,感觉恢复满意.结论 游离腓动脉穿支皮瓣厚薄适中,切取容易,血供可靠,不牺牲动脉主干,可携带皮神经与受区皮神经缝合,同时修复缺损部位感觉,是修复手部皮肤软组织缺损的有效方法之一.
Objective To explore the clinical effects of free flap pedicled with peroneal artery perforator on repair of soft tissue defects in hands. Methods From June 2012 to December 2015, 17 patients with soft tissue defects in hands were repaired by free flaps pedicled with peroneal artery perforator. The defective areas varied from 2.0 cm×3.5 cm to 9.0 cm×10.0 cm. The flap harvesting area varied from 2.5 cm×4.0 cm to 10.0 cm×11.0 cm. The donor sites were closed directly, which diameter was less than 3cm, the others were repaired with skin graft. 32 cases underwent rotator cuff reconstrution by anchor, 32 cases were all sutured by double row type. Results All of the 17 flaps survived. One of them experienced distal end necrosis of epidermis,which healed by dressing change. All donor sites obtained primary healing and skin grafts survived. 17 patients were followed up for 3 to 16 months （mean, 6.2 months）. All flaps survived with satisfactory appearance, sensation and function. Conclusion The free flap pedicled with peroneal artery perforator have constant anatomy, reliable blood supply, and good texture. The thickness of the flap is adequate and the dissection is easy. The cutaneous nerve can be harvested and anastomosed with a cutaneous nerve of receptive site. The flap is a optimal choice for repair of soft tissue defect in hands.
作者
苗平
张秀秀
王瑞
夏既柏
严纪辉
葛华平
MIAO Ping ZHANG Xiuxiu WANG Rui et al(Department of Hand anf Foot Microsurgery, The 464th Hospital of PLA, Tianjin, 300381, China)
出处
《实用手外科杂志》
2017年第2期171-173,共3页
Journal of Practical Hand Surgery
关键词
手
缺损
穿支皮瓣
修复
Hand
Defects
Perforator flaps
Repair
