带蒂旋转皮瓣修复术在手部创面修复中的应用效果

The effect of pedicled rotation flap surgery in the repair of hand wound

目的探讨带蒂旋转皮瓣修复术在手部创面修复中的应用及临床疗效。方法2009年1月～2011年1月，我院诊治的40例手部创伤患者，给予前臂带蒂旋转皮瓣修复术，对其临床疗效和术后并发症进行观察。结果40例手部创伤患者，15例和11例分别使用了前臂桡动脉和尺动脉皮瓣，8例尺动脉腕上皮支皮瓣，6例前臂骨间背侧动脉皮瓣，完成了前臂带蒂旋转皮瓣修复术。40例手部创伤患者术后皮瓣全部成活，成活率为100．0％。其中，25例为优（62．5％），12例为良（30．0％），3例为可（7．5％）。平均随访15个月，所有患者的手部创面弹性较好。与术前相比，术后关节活动度明显增加（P〈0．05），并且恢复正常。术后3例患者发生静脉危象（7．5％），经过及时的处理，皮瓣均恢复正常。结论对于手部创伤而言，前臂带蒂旋转皮瓣修复术取得了较好的临床疗效，值得临床推广。

Objective To study the application and the efficacy of the pedicled rotation flap surgery in the repair of hand wound. Methods All of forty patients with hand wound in our hospital during the period from Jan 2009 to Jan 2011 were clone the forearm pedicled rotation flap surgery. The clinical efficacy and the postoperative complications were observed. Results There were 15 patients and 11 patients done the forearm flap of radial artery and ulnar artery respectively, 8 pa- tients were clone the wrist branch of ulnar artery flap, and 6 patients were done posterior interosseous artery flap for the 40 pa- tients of hand wound. After the surgery all flaps survived with the wound healed and the survival ratio was 100.0%. 25 cases were excellent （62.5%）, 12 cases were good （30.0%） and other 3 cases were general （7.5%）. After follow-up of 15 months, all patients with hand wound flexibility. Compared with the pre-surgery （26.23±9.64）, the range of motion was obviously in- creased （44.35±9.74） （P 〈 0.05）, and returned to normal. 3 patients were venous crisis after surgery （7.5%） and the flaps were normal after timely treatment. Conclusion For the hand wound, the forearm pedicled rotation flap surgery had the better clinical efficacy and worthy of clinical promotion.