股前外侧穿支皮瓣修复手术治疗手外伤组织缺损对患者手部创面面积、组织愈合时间的影响

The effect of repairing hand injury tissue defects with the anterior lateral perforator flap on the wound area and tissue healing time of the patient's hand

目的探讨股前外侧穿支皮瓣修复术治疗手外伤组织缺损的临床效果。方法选取2020年5月-2023年5月长沙市第八医院创伤骨科收治的80例手外伤组织缺损患者,按随机数字表法分为两组,每组各40例。对照组行胸腹部带蒂皮瓣治疗,观察组行股前外侧穿支皮瓣修复术治疗。比较两组修复效果、手部创面面积、组织愈合及抗菌药物使用时间、手功能、上肢功能、疼痛评分、日常生活能力、炎症水平、生活质量及并发症。结果观察组比对照组的修复效果更好(P<0.05);观察组术后手部创面面积小于对照组,创面愈合、抗菌药物使用时间短于对照组(P<0.05);观察组术后MHQ评分、上肢FMA评分、BI评分高于对照组,VAS评分低于对照组(P<0.05);观察组术后CRP、IL-6、IL-8、TNF-α水平低于对照组(P<0.05);观察组术后生活质量各领域评分高于对照组(P<0.05);观察组并发症少于对照组(P<0.05)。结论股前外侧穿支皮瓣修复术效果更佳,可加快手外伤组织缺损患者功能恢复,提高日常生活能力,减轻疾病对生活的影响,且并发症少。

Objective To explore the clinical effect of repairing hand injury tissue defects with the anterior lateral perforator flap of the thigh.Method 80 patients with hand injury tissue defects admitted to the Department of Orthopedics and Trauma at the Eighth Hospital of Changsha City from May 2020 to May 2023 were selected and randomly divided into two groups,with 40 cases in each group.The control group received treatment with a pedicle skin flap in the chest and abdomen,while the observation group received treatment with a perforator skin flap repair in the anterior lateral thigh.Compare the repair effect,hand wound area,tissue healing and antibacterial use time,hand function,upper limb function,pain score,daily living ability,inflammation level,quality of life,and complications between two groups.Results The repair effect of the observation group was better than that of the control group(P<0.05);the postoperative wound area of the observation group was smaller than that of the control group,and the wound healing and antibacterial drug use time were shorter than those of the control group(P<0.05);the postoperative MHQ score,upper limb FMA score,and BI score of the observation group were higher than those of the control group,while the VAS score was smaller than that of the control group(P<0.05);the level of CRP,IL-6,IL-8,TNF-αfor the observation group postoperative was lower than that of the control group(P<0.05);the postoperative quality of life scores in various fields in the observation group were higher than those in the control group(P<0.05);the observation group had fewer complications than the control group(P<0.05).Conclusion The anterolateral thigh perforator flap has a better effect,which can accelerate the functional recovery of patients with hand injury tissue defects,improve their ability of daily living,reduce the impact of disease on life,and have fewer complications.