修薄胸脐皮瓣修复四肢创面

Application of thinning thoracoumibical flap in repair of limb wounds

目的探讨应用修薄后的带蒂或游离胸脐皮瓣对四肢软组织缺损的修复效果。方法采用带蒂胸脐皮瓣修复上肢软组织缺损12例,游离移植修复上、下肢软组织缺损9例。在切取皮瓣时进行修薄,靠近皮瓣中央部需在显微镜下修剪。结果20例皮瓣成活良好,1例坏死。获随访17例,随访时间4个月～5年,皮瓣覆盖处肌腱和骨质无继发坏死、感染;15例皮瓣较周缘皮肤基本平齐或高出2～4mm,2例肥胖患者皮瓣稍显肿胀,但不影响肢体功能。结论应用修薄后的游离或带蒂胸脐皮瓣修复四肢软组织缺损,皮瓣面积大,血管解剖恒定,口径粗,易成活,其外形及功能恢复良好。

Objective To study the clinical effects of repairing the limbs soft tissue defects by free or thinning pedicled thoracoumibical flap. Methods Twelve cases of the soft tissue defects of limbs were treated by thinning pedicled thoracoumibical flap. Transplation of the free skin flap was done in 9 cases to repair the defects of the limbs. The flap was shaped to the size of the receiving site by trimming and thinning. The central part of the flap should be trimed under microscope. Results The results were satisfactory in 20 cases,necrosis was only found in 1 flap. The followed-up was 6 months to 5 years in 17 cases. There was no necrosis and infection in the tendon and bone substance,which was covered by the flaps. The flaps in 15 cases were at the same level or 2-4mm higher than the skin around,in the 2 fat cases,the flaps were a little swelled,but its function was satisfactory. Conclusion The free or thinning pedicled thoracoumibical flaps,which is big surface area full of constant vessels,are easy to survive,and the appearance and function of the limbs are satisfactory.