大面积逆行性皮肤软组织撕脱伤重建静脉回流的临床疗效

Clinical effect of reconstructed reflux on large area retrograde skin and soft tissue avulsion

目的探讨大面积逆行性皮肤软组织撕脱伤重建静脉回流的临床疗效。方法对20例大面积逆行性皮肤软组织撕脱伤患者行撕脱皮瓣浅筋膜内静脉吻合。术后定期随访,观察皮瓣的成活率、肿胀程度、颜色、质地、感觉及毛发生长等情况。结果患者均获得随访,时间3~12个月。20例均未出现感染。18例撕脱皮瓣完全成活,皮瓣轻度肿胀,颜色自然,质地柔软有弹性,有毛发生长,并有不同程度的感觉保留;1例皮瓣表面出现水疱、边缘部分暗黑,未经特殊处理自行痊愈;1例撕脱皮瓣出现部分坏死,经换药、植皮后痊愈。结论大面积逆行性皮肤软组织撕脱伤患者经吻合静脉重建回流后皮瓣成活率高,并且皮瓣的质地、感觉及毛发生长情况较好。

Objective To investigate the effect of reconstructed reflux on the prognosis of large area retrograde skin and soft tissue avulsion. Methods The 20 patients with large area retrograde skin and soft tissue avulsion were oper- ated with flaps veins anastomosed. After operation, those patients were followed ap regularly. The survival rate, swelling degree, colour texture, sensation and hair growth of the flap were observed. Results All patients were fol- lowed up for 3 - 12 months. Twenty patients had no infection after operation, 18 cases of avulsion flap completely were survived with mild swelling, natural colour, soft and flexible texture, hair growth, and varying degree sensation retention ; one case of avulsion flap with blisters on the surface and partial dark edge was healed without special treat- ment;anotber case of avulsion flap was with partial necrosis, after dressing, skin graft got recovery. Conclusions The survival rate of large area retrograde flap avulsion is high after reeonstitution and lhe texture, sensation and hair growth of the flap are better.