“泳裤供区”的髂腹股沟皮瓣修复手背侧及虎口区皮肤软组织缺损的临床应用

Clinical application of ’swimming trunks donor area’ ilioinguinal skin flap in repairing dorsal hand and first web space defects

目的建立"泳裤供区"理念,选取髂腹股沟皮瓣修复手背侧及虎口区缺损,总结这一理念的优势。方法选取身体隐蔽部位的髂腹股沟游离皮瓣移植修复手背侧和虎口区组织缺损18例,缺损面积为3.0 cm×2.0 cm^17.0 cm×9.0 cm。结果 1例皮瓣于术后10 d出现边缘宽约1.0 cm坏死,经清创缝合及伤口换药后愈合,其余17例皮瓣成活良好。术后随访8~24个月,平均9个月。皮瓣厚度适当,不臃肿,色泽及质地良好,无溃疡。根据手部功能评定标准评定,优15例,良3例。髂腹股沟供区瘢痕隐蔽,穿着泳裤即可遮挡。结论应用游离髂腹股沟皮瓣移植修复手背侧和虎口区组织缺损的临床疗效满意,供区瘢痕隐蔽,符合"泳裤供区"理念,是临床上修复手背侧和虎口区缺损的较理想方法。

Objective To establish the concept of ‘swimming trunks donor area’, select ilioinguinal skin flap to repair dorsal hand and first web space defects, and summarize the advantages of this concept.Methods Eighty cases of tissue defect in dorsum of hand and the first web were repaired with free ilioinguinal flaps transplanted from concealed part of the body. The defect area was 4.0 cm ×2.0 cm to10.0 cm× 6.0 cm. Results One case had necrosis of 1.0 cm wide margin 10 days after operation. After debridement, suture and dressing change, the remaining 17 cases survived well. Postoperative follow-up ranged from 8 to 24 months, with an average of about 9 months. The skin flaps are of proper thickness,no swelling, good color and texture, and no ulcer. According to the China evaluation criteria of hand function, 15 cases were excellent and 3 cases were good. The scars in the inguinal donor area were concealed and can be covered by swimming trunks. Conclusion It is an ideal method for repairing dorsum of hand and the first web defect, free ilioinguinal skin flap that using.