腹部带蒂皮瓣联合异体肌腱治疗手背软组织缺损及功能重建

Abdominal pedicle skin flap combined with allograft tendons in repair of soft tissue defect of hand back and functional reconstruction

目的探讨用腹部带蒂皮瓣联合异体肌腱移植一期修复手背软组织缺损及功能重建的方法和临床疗效。方法从2008年1月～2011年2月应用腹部皮瓣修复治疗手背复合软组织缺损,异体肌腱重建伸指功能共9例。9例患者获得随访,术后4周后皮瓣成活。肌腱移植重建伤手功能皮瓣范围为9 cm×5 cm～10 cm×12 cm;异体肌腱移植最多5条/人。结果术后9例皮瓣均成活,外形好;异体肌腱移植效果满意,伤手功能恢复良好。结论腹部带蒂皮瓣加同种异体肌腱移植修复手背侧复合软组织缺损具有损伤小、皮瓣外形好、方法简便及伤手功能恢复满意、治疗时间短等优点,为一种较好的治疗方法。

Objective To investigate the methods and clinical efficacy on the grafting of abdominal pedicled skin flap combined with allogenous tendons for repairing of hand＇s soft tissue defect and functional reconstruction. Methods There were 9 cases by using abdominal skin flap on the dorsum of complex soft tissue defect, and allogeneic tendon reconstructed extensor function from January 2008 to February 2011. Nine patients were received postoperative follow-up, and the flap survived after four weeks. The range of the flap about tendon transplantation for reconstruction of hand function was 9 cmx 5 cm-10 cm^12 cm. Each person could only transplant allogenic tendon at most five. Results The flaps all survived after nine operations, good shape. The effect of tendon allograft was satisfied, and the recovery of hand function was good. Con- clusion The grafting of abdominal pedicled skin flap combined with allogenous tendon to repair soft tissue defect of the dorsum of the hand side composite flap has many advantages： little injury, good shape, simple method and achieved satis- factory recovery of hand function, satisfactory for short treatment time, and it is a better therapeutic method.