组织瓣移植修复手及前臂组织缺损

Repairing defecs in hand and forearm by using vascular flap

目的 报道应用组织瓣移植修复手及前臂组织缺损的临床经验。方法 采用组织瓣移植修复手及前臂组织缺损共２９５例。包括游离组织辨（１３种类型）１８７例，带血管蒂岛状组织瓣（７种类型）９６例，皮神经营养蒂皮瓣１２例。在部分组织瓣移植时采用了组织瓣组合移植、人工血管复合皮瓣移植及联合应用外固定器等特殊方式。结果 有９例失败，２８６例组织瓣成活，成活率为９６．９％。手及前臂组织缺损修复效果满意，经０．５～５年随访，拇手指再造功能良好，皮瓣成活质量满意，骨关节缺损得以重建，感觉恢复达Ｓ３～Ｓ４级。结论 组织瓣移植修复手及前臂组织缺损是一种有效的修复手段，但存在一定失败率，只要严格掌握手术适应证，可达到预期目的。

Objective To report the clinical experience of repairing defecs of hand surgery by using vascular tissue flap. Meth-ods From November 1987 to February 2000, vascular tissue flap in 295 cases. Vessel anastomosed free tissue flap(l3 kinds) was used in 187 cases, vessel pedicle flap(7 kinds) were applied in 96 cases and retrograde - flow island flap pedicle with neurocutaneous collater-al vessel in 12 cases. Combination of ePTFE or external fixators with free flap was used in some cases. Results There was necorisis in 9 out of 286 cases, with a rate of survival was 96 .3 % . After following up for 0.5 - 5 years, all repaired defects and reconstruction were recovered and the effect of repair was good. Conclusion It is effective to repair defects of hand surgery by using vascular tissue flap, when used appropriately.