腹部带蒂超薄皮瓣在手和前臂皮肤软组织损伤中的临床应用

Clinical application of abdominal pedicled ultra-thin skin flap in skin and soft tissue injury of hand and forearm

目的探讨腹部带蒂超薄皮瓣在修复手和前臂皮肤软组织损伤中的治疗效果。方法选取26例(41个皮瓣)创面均在手和前臂的深度创面患者,术中将手和前臂的创面清创,按照清创后创面的形状与大小切取腹部带蒂皮瓣,将皮瓣中远端修薄后转移覆盖到手和前臂的皮肤软组织缺损创面上,术后3周左右断蒂。结果26例患者中,1例患者皮瓣大部分坏死,行截指手术后皮瓣远端少许坏死,经换药后愈合,其余25例患者40个皮瓣均完全成活。术后随访6个月,手和前臂的移植皮瓣不臃肿、质地柔软,无需再行皮瓣修薄手术,外观与功能恢复比较满意。结论应用腹部带蒂超薄皮瓣修复手和前臂皮肤软组织损伤引起的缺损创面具有操作简单、手术安全性高、术后外形与功能恢复佳等优点。

Objective To investigate the therapeutic effect of abdominal pedicled ultra-thin skin flaps for repairing skin and soft tissue injury of the hand and forearm.Methods A total of 26 cases(41 flaps)with deep injuries of hands and forearms were selected.According to the shape and size of the wound after debridement,abdominal pedicled skin flaps were cut off from the abdomen.The middle and distal parts of the flaps were thinned and transferred to cover the skin and soft tissue defects of the hands and forearms.The pedicles were broken about 3 weeks after operation.Results Out of 26 patients,one patient had most of necrosis of the skin flaps.After finger amputation,a little necrosis of the distal part of the skin flaps healed after dressing change.The remaining 25 cases(40 flaps)survived completely.After 6 months follow-up,the transplanted flaps of the hand and forearm were swollen free and soft in texture,and no flaps thinning was needed.The appearance and function of the flaps were satisfactory.Conclusion Abdominal pedicled super-thin skin flaps in repairing defects caused by skin and soft tissue injury of hands and forearms has the advantages of simple operation,higher safety and better recovery in wound shape and function after operation.