静脉动脉化皮瓣游离移植修复四肢小创面的前瞻性临床研究

Prospective Clinical Study on Small Wound of Limbs Repaired by Venous Arterialized Skin Flap Free Grafting

目的:探讨静脉动脉化皮瓣游离移植修复四肢小创面的临床应用价值,为临床提供一种实用有效、存活率高、外观好的修复创面的皮瓣移植方式。方法:选取2012年6月-2013年6月在本院进行皮瓣修复创面手术的30例患者作为研究对象,按照随机数字表法将所有患者分为试验组14例和对照组16例。试验组采用静脉动脉化皮瓣修复,对照组采用经典皮瓣修复,观察比较两组手术时间、住院时间、皮瓣短期(3个月)成活率、供区短期(3个月)一期愈合率、术后1年皮瓣外观和感觉的满意度。结果:两组的缺损面积、手术时间和住院时间的比较差异均无统计学意义(P>0.05)。试验组的皮瓣短期(3个月)成活率100%(14/14)明显高于对照组的62.5%(10/16),供区短期(3个月)一期愈合率100%(14/14)明显高于对照组的56.3%(9/16),且术后1年皮瓣外观和感觉的满意度100%(14/14)明显高于对照组的50.0%(8/16),差异均有统计学意义(P<0.05)。结论:静脉动脉化皮瓣游离移植修复四肢小创面有利于提高皮瓣成活率和一期愈合率,值得临床推广。

Objective：To investigate the value of clinical application on small wound of limbs repaired by arterialized venous skin flap free grafting.Method：30 patients underwent skin flap operation in our hospital from June 2012 to June 2013 were selected as research objects,they were randomly divided into the experimental group for 14 cases and the control group for 16 cases.The experimental group was adopted the arterialized venous skin flap,the control group was adopted classic skin flap.The operation time,length of stay,the flap survival rate of short-term（3 months）,the primary healing rate of donor site for short term（3 months）,the flap appearance and feeling of satisfaction one year after surgery between the two groups were observed and compared.Result：There were no significant differences in defect area,operation time,length of stay between the two groups（P〉0.05）.The flap survival rate of short-term（3 months）in the experimental group was 100%（14/14）,it was significantly higher than 62.5%（10/16）in the control group;the primary healing rate of donor site for short term（3 months）in the experimental group was 100%（14/14）,it was significantly higher than 56.3%（9/16）in the control group;the flap appearance and feeling of satisfaction one year after surgery in the experimental group was 100%（14/14）,it was significantly higher than 50.0%（8/16） in the control group,the differences were statistically significant（P〈0.05）. Conclusion：Small wound of limbs repaired by arterialized venous skin flap free grafting is beneficial to improve the survival rate of skin flap and primary healing rate of donor site,is worthy of clinical promotion.