激光多普勒血流测定对真皮下血管网皮瓣监测的临床意义

Significance of LDF in the Skin-flap with Subdermal Vascular Plexus

目的:探讨激光多普勒血流仪(LDF)在腹部真皮下毛细血管网超薄皮瓣成形术中的临床作用及对治疗的指导意义。方法:2005年7月～2007年11月采用腹部真皮下毛细血管网超薄皮瓣治疗手部、腕部及前臂皮肤套状撕脱伤14例,并采用LDF对围手术期皮瓣供区、皮瓣组织及皮瓣断蒂前血流灌注量(PU)进行监测,评价治疗及监测结果。结果:14例患者在皮瓣成形术后10～17天断蒂,平均13.2天,其中13例患者获得随访,随访时间为2个月～1.3年(平均为8个月)。12例患者随访时皮瓣的外形、色泽、弹性、柔软度均正常,皮瓣PU/周围皮肤PU均大于65%,认定皮瓣断蒂术后成活;1例皮瓣远端断蒂前发生局部坏死。结论:LDF对腹部真皮下毛细血管网超薄皮瓣的临床观察结果对治疗具有重要指导意义。

Objective:To approach laser Doppler flowmetry(LDF)'s clinical effect and significance in the the skin-flap with subdermal vascular plexus.Method:From July 2005 to November 2007,skin flap plasty with subdermal vascular plexus were performed in 14 patients with forearm or hand's avulsed wound.The microcirculation in 14 skin flaps was monitored continuously by LDF.Perfuse unit(PU)of skin flap was analyzed.Results:The pedicle of skin-flap was broken between 10 to 17 days after plasty.The mean value is 13.2 days.13 patients were follow-up visited.The mean follow up was 8 months.The shape,color,and flexibility are generally as same as normal skin.PU of skin flap was 65 percent higher than PU of skin around the skin flap.The flaps were survival in 12 patients,and local necrosis in 1 patient.Conclusion:LDF is a noninvasive technique commonly used to monitor skin perfusion in reconstructive surgery.PU is very important in the treatment of skin-flap with subdermal vascular plexus.