带蒂髂腹部真皮下血管网皮瓣修复手前臂软组织缺损.docVIP

带蒂髂腹部真皮下血管网皮瓣修复手前臂软组织缺损[摘要]目的：探讨带蒂髂腹部真皮下血管网皮瓣修复手前臂软组织缺损的应用价值。方法：2008年8月至2011年1月，对16例手前臂软组织缺损的患者应用带蒂髂腹部真皮下血管网皮瓣进行修复，皮瓣面积9.0cm×5.0cm～15.0cm×20.0cm。供瓣区直接缝合。术后7～18天断蒂。结果：16例皮瓣全部成活，1例皮瓣远端起水疱，表皮坏死脱落，经换药自行愈合。10例获得3～10个月随访，皮瓣外形美观，无继发挛缩，受区外形和患肢功能恢复较满意。结论：带蒂髂腹部真皮下血管网皮瓣血供可靠，应用形式灵活多样，是修复手前臂软组织缺损的一种较理想选择。 [关键词]外科皮瓣；真皮下血管网；手；软组织缺损 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）07-1056-03 Treatment of soft tissue defects in hands and forearms by subcutaneous vascular net flap from lower abdomen LIU Wen-jian1,WEN Hui-cai2,FU Jian-hua2,YAO Yu-ting2,YANG Hong-hua2 (1.Department of Burns and Plasty,Jiangxi Provincial Corps Hospital,Chinese People’s Armed Police Forces,Nanchang 330030,Jiangxi,China;2.Department of Plastic and Aestletic,The Affiliated Hospital,Nanchang University) Abstract:ObjectiveTo investigate the application of subcutaneous vascular net flap from lower abdomen for soft tissue defects in hands and forearms.MethodsFrom August 2008 to January 2010, 16 cases with soft tissue defects in hands and forearms were treated using subcutaneous vascular net flap from lower abdomen,flap size ranged from 9.0cm×5.0cm to 15.0cm×20.0cm.The defects in lower abdomen were closed directly.7～18 days postopration,cut off the pedicles.ResultsFlaps all survived,all wounds were primarily healed.1 cases suffered delaying healing because of flap epidermis necrosis of the distal part.10 cases were followed up for 3 to 9 months with satisfactory aesthetic and functional results in the recipient areas,no contracture appearance.ConclusionsThe subcutaneous vascular net flap from lower abdomen has rich blood supply and great flexibility,which is practical and suitable for repair of soft tissue defects in hands and forearms． Keywords:surgical flaps；subcutaneous vascular net；hand；soft tissue defect 手和前臂是人体的暴露部位和劳动器官，常因遭受各种外伤（包括撕脱伤、烧伤、挤压伤等）或后期整复导致皮肤软组织缺损，严重时伴有神经血管束、肌腱或骨关节外露、损伤或缺损，因对功能和外形要求高，其修复比较棘手。2008年8月～2011年1月，笔者采用髂腹部真皮下血管网皮瓣修复手前臂软组织缺损16例，获得满意效果。 1资料和方法 1.1 应用解剖：腹壁浅动脉发自股动脉，发出点