摘要
目的探讨吻合一组血管的联合皮瓣的应用价值。方法本组36例均为车祸伤，损伤部位在膝、小腿或踝足部、上肢。创面超大，皮肤缺损伴骨关节、肌腱裸露，选用吻合一组血管的联合皮瓣修复，其中吻合肩胛下血管肩胛一侧胸联合皮瓣7例，最大为70cm×10cm；吻合肩胛下血管侧胸一背阔肌联合皮瓣9例，最大为42cm×24cm（1008c㎡）；吻合肩胛下血管的肩胛一背阔肌联合皮瓣2例；吻合旋股外侧血管与股外侧皮神经的大腿前内侧一阔筋膜张肌联合皮瓣8例；吻合胫前血管与腓浅神经的踝前一足背联合皮瓣5例；吻合足背血管与腓浅神经的趾伸短肌一足背联合皮瓣5例。结果随访1．5～25．0年，其中有23例随访19年，皮瓣全部成活，创面全部得到覆盖，感染伤口治愈，未再发生溃疡，皮瓣外观好；皮肤恢复了感觉；骨折愈合，保住了肢体，未发生截肢；5例前臂屈肌腱及4例膝关节行松解，为功能恢复创造了条件。结论吻合一组血管的联合皮瓣能代替吻合多组血管的组合皮瓣，节时、省事，成功率高，拓宽了适应证。
Objective To explore the value of a set of combined vascular anastomosed flap. Methods The 36 cases were injured, the site of injury in knee and leg or ankle and foot, upper limb. Skin defect with bone and joint, tendon exposure. Selection of anastomosis of blood vessel with large flap, wherein the subscapular vascular anastomosis scapular-lateral thoracic flap in 7 cases, the maximum was 70 cm× 10 cm; anastomosis of subscapular artery lateral thoracic-latissimus dorsi muscle flap in 9 cases, the maximum was 42 cm × 24 cm. Anastomosis of subscapular artery of the scapular-back the latissimus dorsi muscle flap in 2 cases; anastomotic lateral circumflex femoral vessels with lateral femoral cutaneous nerve thigh anterior medial-tensor fascia latae flap in 8 cases ; anastomosis of anterior tibial artery and the superficial peroneal nerve in the anterior ankle-dorsal foot flap in 5 cases; anastomosis of dorsal vessels and superficial peroneal nerve of the extensor digitomm brevis muscle-dorsal foot joint flap in 5 cases. Results Following up 8 months to 25 years, twenty-three cases were 19 years. All flaps survived and all the wounds were covered, infection were cured, the skin have aesthesia, fracture healing. Five cases were performed muscle tendon and arthrosis solution for creating conditions for the functional recovery of limb. Conclusion Anastomosis of blood vessel anastomosis combined flap can replace multiple vascular flaps combination, saving, convenient, high success rate, widen the indications.
出处
《中华显微外科杂志》
CSCD
北大核心
2013年第3期215-219,共5页
Chinese Journal of Microsurgery
基金
全军医药卫生重大科研课题基金（20030216）
关键词
侧胸一背阔肌联合皮瓣
肩胛下动脉
吻合血管
巨大创面
显微外科
Combined flap of lateral thoracic-latissimus dorsi muscle
Subscapular artery
Anastomosis of blood vessel
Large wound
Microsurgery
