腹部多个真皮下血管网皮瓣修复手指脱套伤

Multiple abdominal skin flaps with subdermal vascular network to treat degloving injury of fingers

目的:简化多个手指脱套伤的修复方式。方法:1993年起,作者用腹部多个真皮下血管网带蒂皮瓣修复2个以上手指环形脱套伤,共5例12个手指。皮瓣设计在对侧下腹部或同侧脐旁,皮瓣面积4.0cm×5.0cm^6.0cm×10.0cm,断蒂时间为术后7~14天。结果:皮瓣全部成活,经0.5~2.0年随访,指蹼自然分开,无瘢痕挛缩,外形美观,运动功能基本恢复。结论:该术式二次即能修复多个手指脱套伤,与传统的腹部带蒂皮瓣相比,简化了手术,不需进行分指及皮瓣修薄术。

<Abatract>Objective: To simplify the method for treating degloving injury of multiple fingers. Methods: Multiple abdominal skin flaps with subdermal vascular network were used to repair skin and soft tissue defects after degloving injury of more than 2 fingers in the hand. Five patients including 12 fingers were treated from 1993. The flaps were harvested from the hypogastric or paraumbilical region. The size of the flaps were 4cm × 5cm to 6cm × 10cm. The pedicle was detached in 7 to 14 days after transfer. Results: All the flaps survived. There was no scar contracture at the web spaces. The contour and function of the fingers were satisfactory. Conclusions: This method is simple compared to the conventional procedures. Secondary surgeries of parting the fingers and thinning the flaps are no longer necessary.