游离腹股沟分叶皮瓣在手部复杂创面修复中的应用

The application of free groin multifoliate flaps to repair complex soft tissue defects of the hand

目的探讨应用游离腹股沟分叶皮瓣移植修复手部复杂创面的方法以及临床治疗效果。方法自2012年3月至2019年5月,我们对11例复杂的手部皮肤及软组织缺损创面,其中手掌手背贯穿创面3例,手掌套脱创面2例,多处皮肤缺损创面6例,设计以腹壁浅动脉与旋髂浅动脉为蒂的分叶皮瓣修复。切取皮瓣面积为5.0 cm×3.0 cm~12.5 cm×7.0cm。结果术后10例皮瓣一期存活,1例分叶皮瓣远端坏死,换药治疗1个月后创面瘢痕愈合。术后随访时间为6~18个月,平均9个月,皮瓣质地和外观优良。结论应用游离腹股沟分叶皮瓣移植修复手部复杂创面,可一次手术完成修复,皮瓣成活率高、供区隐蔽、瘢痕小,是修复复杂手部创面的一种较可靠的治疗方法。

Objective To explore the method and clinical efficacy of the free groin multifoliate flaps in the repair of complex soft tissue defects of the hand.Methods From March 2012 to May 2019,11 cases of complex soft tissue defects of the hand were treated,including 3 cases of penetrating wound of the hand,2 cases of degloving wound of the palm,and 6 cases of multiple skin defect wounds.A lobulated flap pedicled with superficial abdominal artery and superficial circumflex iliac artery was designed to repair the wound.The area of the flap was 5.0 cm×3.0 cm to 12.5 cm×7.0 cm.Results After operation,10 flaps survived unevenfully,and 1 case of lobulated flap with necrosis in the distal part achieved scar healing after dressing change for 1 month.The follow-up time ranged from 6 to 18 months,with an average of 9 months.The texture and appearance of the flap were ecellent.Conclusion The application of free groin multifoliate flaps can be used to repair complex soft tissue defects of the hand in one operation.The flap has the advantages of high survival rate,hidden donor area and small scar.It is a reliable method to repair complex hand wounds.