骨间背皮瓣、游离足背皮瓣治疗手背大面积皮肤缺损的比较研究

Effect of free Dorsalsi Pedsi Flap of r the Treatment of Large Area Sk in Dfe ect of HandD orsum

目的：探讨游离足背皮瓣治疗手背大面积皮肤缺损的效果。方法：选取2010年1月～2013年12月期间我院收治的64例手背大面积皮肤缺损患者为研究对象。将80例患者随机分为观察组和对照组。观察组：32例，给予足背皮瓣修复手部创面；对照组：32例，给予骨间背皮瓣修复手部创面。统计2组皮瓣成活情况、皮瓣外形、手部关节活动度、供区损伤情况、供区疼痛情况、日常生活受限程度。结果：观察组皮瓣成活情况明显优于对照组（ P＜0．05）。观察组皮瓣外形明显优于对照组（ P＜0．05）。观察组手部关节活动度稍优于对照组，但2组无统计学差异（P＞0．05）。观察组供区损伤情况明显轻于对照组（P＜0．05）。观察组供区疼痛情况明显轻于对照组（P ＜0．05）。观察组日常生活受限程度稍轻于对照组，但2组无统计学差异（ P＞0．05）。结论：与骨间背皮瓣相比，采用游离足背皮瓣对手背大面积皮肤缺损进行修复治疗，皮瓣外形和皮瓣成活情况更佳，供区损伤程度和疼痛感更轻，因此更适合手背大面积皮肤缺损的治疗。

Objective：To study effect of free dorsal pedis flap for the treatment of large area skin defect of hand dorsum .Methods：During the period from 2010 January to 2013 December 64 cases of large area patients with skin defect of the dorsum of the hand in ournbsp;hospital were selected as the research object .64 patients were randomly divided into observation group and control group .The observation group：32 patients, giving the dorsal pedis flap to repair the wound of hand;control group：32 patients, giving the dorsal interosseous flap to repair the wound of hand.Statistics and flap survival situation, flap, hand joint activities, for the District of injury, for the pain, limita-tions of daily living of the two groups were compared .Results：The observation group＇flap survival was significantly better than the control group （P〈0.05）.The observation group＇flaps were significantly better than the control group （P〈0.05）.The observation group＇hand joint activity degree was slightly better than that of the control group , but no significant difference between two groups （P〉0.05）.The observation group＇damage district was lighter than that of control group （P〈0.05）.The observation group＇donor site pain was significant-ly less than that in the control group （P〈0.05）.The observation group＇daily life confined to a lesser extent than the control group , but no significant difference between two groups （P〉0.05）.Conclusion：Compared with the dorsal interosseous flap , using free dorsal pedis flap for large area skin defect of hand dorsum , its flap and skin flap survival situation is better , the district＇injury degree and pain is light-er, therefore it is more suitable for treatment of large area skin defect of hand dorsum .