上臂带蒂皮瓣修复多个手指创伤性皮肤缺损

The Primary Repair of Traumatic Skin Defect in Multiple Fingers Treated with Pedicle Skin Flaps of Opposite Upper Arm

作者报告1983～1994年间，应用上臂带蒂皮瓣一期修复伴有肌健、神经、血管或骨关节裸露的多个手指创伤性皮肤缺损32例（69个手指）。其中男性28例，女性4例。切割伤8例，撕脱伤10例，挫裂伤14例。伤后就诊时间，最短半小时，最长10小时。术后两周断蒂，皮瓣全部成活，手指功能与外形恢复满意。作者认为，在显微外科技术和显微外科解剖学迅速发展和普及的今天，利用上臂带蒂皮瓣一期修复伴有肌腱、神经、血管或骨关节裸露的多个手指创伤性皮肤缺损，仍有一定的临床应用价值。作者还对皮瓣断蒂的最早时限进行了讨论，认为在一定条件下，带蒂皮瓣移植术后两周断蒂是可行的。

32 cases (69 fingers) of traumatic skin defect inmultiple fingers with exposed arteries, nerves, tendons,bones or joints had been treated by using the pedicleskin flaps of the opposite upper arm from 1983 to 1994.Among 32 cases, the incised wound was happened in 8cases, the avulsed wound in 10 cases, and the laceratedwound in 14 cases;two fingers were wounded in 27 casesand three fingers in 5 cases. All of them were emergentcases and the pedicle skin flaps were all alive. Thus thewriter considered that this method may be used inemergent case. The earliet time for cutting the pedicle ofskin flap was discussed.