腹部带蒂的薄皮瓣修复上肢关节皮肤软组织缺损

Repairation of the skin and soft tissue defection in upper limb joint with pedicled abdominal thin flap

目的探索修复上肢关节部位皮肤软组织缺损的理想方法。方法本组12例病人，烧伤和外伤后，手部及肘关节严重的瘢痕挛缩，切除瘢痕，彻底松解后，出现皮肤软组织缺损，肌腱、骨外露，应用腹部带蒂薄皮瓣移植修复后固定，二次断蒂。结果术后21天后断蒂，12例皮瓣全部成活。切口愈合后，配合功能锻炼，关节活动明显改善，随访3～24个月，肘关节及手功能恢复满意。结论上肢关节处烧伤和外伤后皮肤软组织缺损所致功能障碍，应用腹部带蒂薄皮瓣修复，关节功能恢复良好，外形满意，值得推广。

Objective To explore an ideal operative method to repair the skin and soft tissue defection in upper limb joint. Methods Treated 12 patients with severely cicatricial contraction in hands and elbows after burn or trauma. All of them were given oulectomy to relax the articulus enough, skin and soft tissue defection occurred, some cases had muscle tendon or bone exposure, the pedicle abdominal thin flap were used to repair them, second operation was given to cut off the pedicels. Resuits 21 days postoperation, cut off the pedicels, the pedicle abdominal thin flap in 12 cases were satisfactory. After wound healing, functional exercise was done, their joint function were improved evidently, 3 - 24 months later, the elbow joint and hand had satisfactory function. Conclusions The pedicle abdominal thin flap was a good method to repair the skin and soft tissue defection caused by burn or trauma in upper extremity joint, the joint function and appearance recovered well postoperation.