短蒂腹部交叉皮瓣修复手部创面临床应用.docVIP

短蒂腹部交叉皮瓣修复手部创面临床应用[摘要]目的：探讨短蒂腹部皮瓣修复手部创面的广泛适用性及改进方法。方法：通过改进皮瓣设计及闭蒂方式、采用短蒂腹部皮瓣修复手部创面25例32处，手指19例（其中同侧双指3例、三指2例）、手背6例。皮肤缺损范围：最小1.5cm×2.0cm、最大12cm×16cm。皮瓣范围：最小1.8cm×2.5cm、最大13cm×18cm。结果：所有皮瓣蒂部均一期闭合、术后一周蒂部干洁、皮瓣成活良好、质地外观佳，手功能恢复良好。结论：腹部皮瓣修复手部创面大多无需设计皮管，改进皮瓣设计及闭蒂方式的短蒂腹部皮瓣即可达到封闭创面、减少渗出及感染机会，同时提高皮瓣利用率、减少副损伤、避免皮管臃肿、积血影响血供、促进血循环及感觉重建、可早期断蒂、利于功能恢复、外形更薄。 [关键词]蒂部；腹部皮瓣；手部创面；设计改进；临床应用 [中图分类号]R622 [文献标识码]A [文章编号]1008-6455（2013）01-0118-02 Clinical Application of the Abdominal Flap with Short Pedicel for the Wound of Hand TIAN Heng， LIU Hong-jun， GU Jia-xiang， ZHANG Nai-chen， PAN Jun-bo， ZHANG Wen-zhong （Northern Jiangsu People’s Hospital Affiliated to Yangzhou University， Hand surgery， Yangzhou 225001，Jiangsu，China ） Abstract： Objective To discuss the extensive feasibility and improved methods of the abdominal flap with short pedicel for the wound of hand. Methods 25 cases with 32 wounds in their hands were repaired by the improved abdominal flap with short pedicel，which improved in the flap design and methods of pedicel closure， of whom 19 cases with the skin defect of the fingers（3 cases of whom with double fingers defect in the same hand， and 2 cases of whom with three fingers ）， other 6 cases’ wound on the back of the hand. The size of skin defect was 1.5 cm × 2.0 cm to 12 cm ×16cm；the size of the flaps was 1.8 cm × 2.5 cm to 13 cm ×18cm. Results All cases’ pedicel were closed in operation and dry in a week after operation， all flaps achieved a complete survival、the texture and appearance were satisfying，and hand function were good. Conclusion Skin tube was unnecessary for the abdominal flap to repair the wound of hand generally， the improved abdominal flap with short pedicel which improved in the flap design and methods of pedicel closure also could close wound、decrease exudation and infection probability，and increase the utilization rate of flap、reduce additional damage、avoid swollen sikn tube and hematocele to affect the flap’s blood supply，promote blood circu