多类型桡动脉掌浅支腕横纹部游离皮瓣在手指复合软组织缺损治疗中的应用研究

Effect of multiple types of free flap of transverse carpal vein with superficial palmar branch of radial artery in treatment of composite soft tissue defect of finger

背景:游离皮瓣移植在软组织缺损修复治疗中成活率高,且可用于肉芽不新鲜创面修复中。目的:分析多类型桡动脉掌浅支腕横纹部游离皮瓣在手指复合软组织缺损治疗中的应用价值。方法:回顾性分析我院2018年5月至2020年1月收治的手指复合软组织缺损患者70例,按手术治疗方法不同分为对照组和研究组。对照组实施局部带蒂转移皮瓣修复治疗,研究组实施多类型桡动脉掌浅支腕横纹部游离皮瓣修复治疗,对比两组缺损修复效果、手术时间、术中出血量、创面愈合时间、术后并发症发生率及患者满意度。结果:研究组缺损修复优良率94.4%,高于对照组的76.5%(P<0.05);两组术中出血量差异无统计学意义(P>0.05);研究组手术操作时间长于对照组,但创面愈合时间短于对照组(P<0.05);研究组术后并发症发生率8.3%,低于对照组的26.5%(P<0.05);研究组患者总满意度97.2%,高于对照组的82.4%(P<0.05)。结论:桡动脉掌浅支腕横纹部游离皮瓣在手指复合软组织缺损治疗中有较高价值,术后创面愈合快且并发症少,可有效提升缺损修复效果并获取较高患者满意度。

Background:Free skin flap transplantation has a high survival rate in the repair of soft tissue defects,and can be used in the repair of stale granulation wounds.Objective:To analyze the effect of multiple types of free flap of transverse carpal vein with superficial palmar branch of radial artery in the treatment of composite soft tissue defects of fingers.Methods:A total of 70 patients with finger composite soft tissue defect admitted to our hospital from May 2018 to January 2020 were selected and divided into control group and study group.The control group was treated with local pedicled flaps,while the study group was treated with multiple types of free flaps of the transverse carpal vein of the superficial palmaris of the radial artery in the finger composite soft tissue defect.The defect repair effect,operation time,intraoperative blood loss,wound healing time,incidence of postoperative complications and patient satisfaction were compared between the two groups.Results:The excellent and good rate of defect repair in the study group was 94.4%which was higher than that in the control group(76.5%,P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).The operation time of the study group was longer than that of the control group,but the wound healing time was shorter than that of the control group(P<0.05).The incidence of postoperative complications in the study group was 8.3%,lower than that in the control group(26.5%,P<0.05).The total satisfaction of patients in the study group was 97.2%,higher than that in the control group(82.4%,P<0.05).Conclusions:The free flap of the transverse carpal vein with the superficial palmar branch of radial artery has relatively high value in the treatment of finger composite soft tissue defect.With it patients can have faster wound healing and fewer complications,the defect repair effect can be effectively improved,and higher patient satisfaction can be achieved.