简单皮瓣修复术在手外伤治疗中的应用

Application of simple flap repair in the treatment of hand injury

目的探讨在手外伤致皮肤软组织缺损病例中应用简单皮瓣修复技术的临床效果。方法以我院自2008年1月-2009年5月收治的手外伤致皮肤软组织缺损病例19例为研究对象,其中单纯皮肤软组织缺损10例,合并肌腱、骨外露4例,合并感染者3例,单纯指体远节缺损者2例,根据其手部皮肤软组织缺损的性质、部位、缺损大小等,选择采取腹部带蒂皮瓣、邻指皮瓣、中厚皮片移植等简单皮瓣技术进行修复。结果对19例患者行简单皮瓣修复,17例成活,2例腹部带蒂皮瓣因术后发生挤压致皮瓣缺血经纠正后成活,1例腹部带蒂皮瓣断蒂后出现皮缘部分坏死,经积极换药后愈合。术后继续随访2～6个月,移植皮瓣颜色与正常皮肤接近,弹性佳,无挛缩,手外形及功能恢复良好,日常生活影响不明显。结论简单皮瓣修复术在治疗手外伤软组织缺损时,手术方法简单,皮辨成活率高,对正常组织损伤小,术后手功能恢良好,不失为临床治疗手部皮肤软组织缺损的一种较好方法。

Objective To explore application of simple flap repair in the treatment of hand injury. Methods 19 cases patients with hand injury admitted in our Department from January 2008-May 2009 were used as research objects, including simple skin and soft tissue defect 10 cases, combined with tendons, bones exposed 4 cases, combined with infected with HIV in 3, pure refers to the body the defect is far quarter 2 cases. According to skin and soft tissue de- fect of hands property, position, defect size etc, it was chosen to take abdominal pedieled skin flap, flap in neighbor- ing refers to,thick skin grafts of simple flap technique to repair them. Results Of the 19 patients treat with simple flap repair, 17 cases survived ,2 cases of abdominal pedieled skin flap for extrusion occurred after the flap isehemia after the correct survival,and 1 case abdominal pedieled skin flap off appears after the skin~ margin part necrosis, the positive after change healing. Postoperative continue to follow-up 2 - 6 months, with normal skin flap transplan- tation color close to, good elasticity, no eontracture, hand shape and function restore good, affect daily life is not clear. Conclusion Simple flap repair as the surgical method to treat hand injury of soft tissue defect is simple ,with high skin survival rate, small normal tissue clinical method in the treatment of skin and damage, good postoperative soft tissue injure and defect hand function; it can be regarded as good of hands.