腹部带蒂皮瓣设计改进及临床应用

REFORM OF THE PEDICLED ABDOMINAL FLAP AND ITS CLINICAL APPLICATION

目的 探讨传统腹部带蒂皮瓣切取后 ,皮瓣供区创面的闭合方法。 方法 按设计切取下腹带蒂皮瓣(供移位皮瓣 )后 ,以皮瓣蒂左右为起点分别以弧线向两侧延长切口至髂前上棘 ,通过分离形成可向移位皮瓣供区创面移动的对侧和同侧腹壁皮瓣 (供覆盖腹壁创面皮瓣 ) ,通过此皮瓣向相对应方向推移 ,闭合供移位皮瓣创面。 1998年 9月～2 0 0 3年 9月临床应用 12例 ,男 5例 ,女 7例。急诊手术 4例 ,择期手术 8例。病程 2 8～ 6 2 d。皮肤缺损为 7cm× 11cm～12 cm× 13cm。 结果 经皮瓣设计改进 12例 ,均一期闭合移位皮瓣供区创面 ,12例皮瓣全部成活。 1例覆盖腹壁创面皮瓣 (皮瓣对侧 )尖端坏死 ,范围 1.5 cm× 2 .0 cm,经换药后痊愈 ,其余供覆盖创面皮瓣均 期愈合。 结论 应用改进设计的腹部带蒂皮瓣 ,可免除较大皮瓣创面的植皮手术 ,为临床治疗提供了一种方法。

Objective To investigate the closing method of wound after removal of the traditional pedicled abdominal flap. Methods According to the design, the pedicled abdominal flaps were cut and lifted, and then the incision were extended from both sides on base of the flap to anterior superior iliac spine, respectively. After separating on superficial fascia, two flaps were obtained. The wound of donor site was closed completely by these two pedicled flaps. Twelve patients with skin defects on hands or forearms were treated using the reformed method of traditional pedicled abdominal flap. Results All of the 12 reformed pedicled abdominal flaps survived, and only one had local necrosis on the distal part of the abdominal flap, about 1.5 cm ×2.0 cm. Conclusion This new design could provide a good method to close the abdominal wound after removal of pedicled abdominal flap. ?t?t?3/4