带神经、血管预构皮瓣的动物实验及临床应用研究

Experimental study of prefabricated flaps on animal model and clinical application on patients

目的 探讨带神经、血管的预构皮瓣治疗四肢严重皮肤缺损的可行性。方法 动物实验:新西兰大耳白兔15只,随机分为3组各5只。A组:植入腹壁下动静脉血管束;B组:植入阴部外动静脉血管束;C组:植入股动静脉血管束及部分股神经。术后3周观察血管、神经生长情况。临床应用:手背皮肤缺损患者2例,用腹壁下深动脉和股外侧皮神经转移至腹壁皮下预构皮瓣,修复创面。结果 动物实验:3组预构皮瓣血管生长良好,C组可见少量神经纤维和轴突向远端生长。临床应用:2例患者皮瓣全部成活良好,且有皮肤浅感觉。结论 预制带神经、血管的皮瓣并用于治疗四肢严重皮肤缺损是可行的。

Objective To study the feasibility of the application of the prefabrication flap in the se rious skin defect of extrimites.Methods Animal experiments:15 New Zealand white rabbits were divided into three groups.Group A was implanted the inferior epigastric artery and vein,Group B was the external pedendal artery and vein,Group C was the femoral arte ry,vein and nerve.All the models were observed directly or under microscope.C linical application: Select 2 patient which were injured on the hands.Firstly ,transfered the deep inferior epigastric artery and lateral femoral cutaneous n erve to the subcutaneous of the abdomen,then repaired the wounded area of the d orsum.Results Animal experiments:The blood vessels under the prefabricated flaps survived well.Some nerve fiber and axons were seen growing toward distal end in group C.Clinical application:The flaps of the 2 patients were survived well,and the sensation of the skin were recovered.Co nclusion Prefabricated flaps with vessels and nerves are feasible i n the treatment of the serious skin defect of extrimites.