超薄臂内侧穿支皮瓣游离移植修复手部皮肤深度缺损

Free transplantation of the ultra-thin upper arm medial perforator flap in repairing the deep defect of hand skin

目的探讨超薄臂内侧穿支皮瓣游离移植修复手部皮肤深度缺损的疗效。方法采用超薄臂内侧穿支皮瓣游离移植修复16例手部皮肤深度缺损患者。皮肤缺损面积4.0 cm×1.5 cm~8.0 cm×5.0 cm,皮瓣设计切取面积4.0 cm×2.0 cm~8.0 cm×6.0 cm。结果16例皮瓣中15例顺利成活,1例术后出现血管危象,经探查修复手术后成活。患者均获得随访,时间3~20个月。移植皮瓣外形、色泽、弹性良好,不需要二期修薄。末次随访时,手部关节活动不受限,无手部功能障碍;皮瓣两点辨别觉为5~10 mm。结论超薄臂内侧穿支皮瓣游离移植修复手部皮肤深度缺损,供区较隐蔽,皮肤色泽与周围接近,皮瓣质地好,无需修薄,便于恢复受区外形与功能,是修复手部软组织缺损的较理想方法。

Objective To investigate the effect of the ultra-thin upper arm medial perforator flap in the repair of the deep defect of hand skin.Methods The 16 cases with the deep defect of hands skin were repaired by ultra-thin upper arm medial perforator flaps.The skin defect area was 4.0 cm×1.5 cm~8.0 cm×5.0 cm,and the designed cut area of flap was 4.0 cm×2.0 cm~8.0 cm×6.0 cm.Results In the 16 cases,15 cases smoothly survived,and 1 case had vascular crisis,and the flap survived after the exploratory repair.All 16 cases were followed up from 3 months to 20 months.The flaps completely survived.The flaps color,texture and elastic were good,no need for thinning of two-stage.At the last follow-up,the joint activity of the hands was not limited,without dysfunction of the hand;and the two-point discrimination was 5~10 mm.Conclusions Free transplantation of ultra-thin medial upper arm perforator flap for repairing deep skin defect of hand is an ideal method for repairing soft tissue deep defect of hand skin.The donor area is relatively concealed,the skin color is close to the surrounding area,and the flap has good texture,which is easy to recover the appearance and function of the recipient area,without thinning.