带蒂腹部真皮下血管网皮瓣设计的改进及临床应用

REFORM OF THE PEDICLED ABDOMINAL SUBCORIUM VASCULAR NET FLAP AND ITS CLINICAL APPLICATION

为了寻求传统腹部带蒂皮瓣移植后，避免用皮片移植覆盖供皮瓣区创面的皮瓣设计方法，以原设计皮瓣蒂部两端的某一端为圆心，向蒂部方向旋转４５°，形成新的皮瓣蒂，再以此为蒂，按原设计皮瓣大小、形态设计新的皮瓣。结果表明，将新设计的皮瓣掀起，形成真皮下血管网皮瓣，其皮瓣蒂及残留在腹壁上相邻的皮肤缘，通过推进缝合，覆盖了供皮瓣区创面，其蒂部也随之转回原设计位置，又形成了与蒂部平行的皮肤缘。改良带蒂腹部真皮下血管网皮瓣具有皮瓣薄，断蒂时间短，可直接封闭皮瓣供区创面等优点。临床应用２８例，术后５天～７天断蒂，皮瓣全部成活。

In order to resolve the shortcomings of traditional pedicled abdominal skin flap, the pedicled abdominal subcorium vascular net flap was reformed and applied clinically. Twenty eight cases with scar on hand or wrist were treated, including 20 males and 8 females. The age was ranged from 18 to 35 years old. The key point in the design was rotating 45° of the flap from the primary site toward the pedicle. The ratio of the length to width of the flap was 1～1.8∶1, and the wound of the donor site was covered by direct suture. Five to seven days later, all the flaps were divided and survived. The advantages of this flap were as follows: skin grafting on the donor site was not necessary; the time needed for cutting the pedicle was shortened, and the flap is thinner than the traditional flap.