游离上臂外侧分叶皮瓣在手部多创面皮肤缺损中的应用.pdfVIP

游离上臂外侧分叶皮瓣在手部多创面皮肤缺损中的应用  黄剑、郑远圆、李基民、王晓峰、李学渊、陈宏  【摘要】：目的 探讨游离上臂外侧分叶皮瓣修复手部多处有深部组织外露创面的临床 疗效。方法 2009 年 10 月~2011 年12 月 对 15 例同时患有手部2～3 处皮肤软组织缺 损伴骨、肌腱外露创面的患者，择期采用游离上臂外侧分叶皮瓣进行修复。其中手掌部 皮肤缺损伴手指皮肤缺损患者6 例，手背伴手指皮肤缺损4 例，手掌伴手背皮肤缺损3 例。两指皮肤缺损2 例。结果  随访6～24 个月皮瓣均成活。成活后皮瓣质地优良，外 形与功能恢复满意。结论 利用桡侧副动脉皮穿支设计的上臂外侧皮瓣血管解剖恒定， 血管蒂长，是修复手部多处皮肤缺损的有效方法。  【关键词】  桡侧副动脉  皮肤缺损  外科皮瓣 移植  The application of multifoliate flaps based on raial colateral artery to repair multiple soft tissue defects of the hand Huang Jian, Zheng Yuanyuan, Li Jimin, Wang Xiaofeng, Li Xueyuan, Chen Hong 【 abstract 】 Objective To explore the application of multifoliate flaps based on lateral arm to repair multiple deep tissue deffects of the hand and its clinical outcome. Method Since October 2009 to December 2011, we received 15 cases who had more than one soft tissue defects over their hand with tendon or bone exposed, including 6 cases with volar hand skin defect and finger skin defect; 4 cases with dorsal hand defects and finger skin defects; 2 cases had more than one finger skin defects. 3 cases with both volar and dorsal defects . Free multifoliate flaps based on radial colateral artery were used to repair those complecated skin and soft tissue diffects. Result All cases were followed up for 6 ~ 24 months,all flaps survived with satisfied appearance and function. Conclusion Multioliate flaps based on radial colateral artery are effective for repair more than one skin and soft tissue defects over one hand,using only one vascular pedicle. 【 key words 】Lateral arm soft tissue defects multiple 伴有骨、肌腱外露的手部多创面皮肤软组织缺损是较为严重的手外科创伤。常由高 能量的冲击贯穿伤、磨擦伤、热压伤等因素引起。由于累及多个独立创面，单一皮瓣难 以一次修复，往往需要同时设计多个皮瓣进行修复。或予分次进行修复。前者增加了手 术风险，后者病程长效果均不太理想。2009 年 10 月~2011 年 12 月我院应用游离上臂 外侧分叶皮瓣对此类创面进行一次性修复。取得了良好的效果。报道如下。  1  资料与方法  1.1 一般资料 本组15 例均为双叶分叶皮瓣，男11 例，女4 例；年龄21—48 岁， 平均32.5 岁。受伤原因：工业贯穿伤5 例，枪击贯穿伤 1 例，车祸摩擦伤2 例，工业摩擦伤 5 例，热压伤 2 例。受伤部位：手掌部皮肤缺损伴手指皮肤 缺损