摘要
目的探讨邻近筋膜皮瓣修复胫前区骨、钢板外露小创面的临床效果。方法2014年1月-2016年12月,笔者单位收治胫前区小面积骨、钢板外露患者12例,创面面积为2cm×2cm^5cm×3cm。彻底清创后在创面内侧或外侧正常皮肤处根据创面大小设计圆形或椭圆形邻近筋膜皮瓣,皮瓣蒂部位于近端,切取后通过皮下隧道转移覆盖创面。本组皮瓣切取面积3cm×3cm^6cm×4cm。间断缝合皮瓣,皮瓣下放置引流皮片,24~48h内拔除,供瓣区以同侧大腿外侧中厚皮片修复。结果本组9例患者皮瓣全部成活;2例患者皮瓣远端出现小面积坏死,经换药后愈合;1例患者皮瓣出现张力性水疱,去除水疱,改善循环后皮瓣存活良好。随访3个月,皮瓣血运、外观、色泽良好,感觉减退。结论以邻近筋膜皮瓣修复胫前区骨、钢板外露小创面手术操作简单、不损伤知名血管,皮瓣外观、质地及厚度均接近于胫前区皮肤,是修复该类创面的较好选择,值得临床推广应用。
Objective To explore the clinical effects of adjacent fascioeutaneous flaps in repairing small wounds with bone or steel plate exposure in anterior tibia.Methods Twelve patients with small wounds of bone or steel plate exposure in anterior tibia covering area of 2cm×2cm to 5cm×3cm were admitted to our unit from January 2014to December 2016.A circular or elliptical adjacent fascioeutaneous flap was designed on the normal skin located at the inside or outside of the wound according to the size of wound after thorough debridement.The pedicle of the flap was located at the proximal end and transferred through the subcutaneous tunnel to cover the wound.The sizes of flaps were 3cm×3cm to 6cm×4cm.Flaps were fixed with interrupted sutures and drainage rubber sheets were placed under the flaps.The drainage rubber sheets were removed within 24to 48hours.The donor area was repaired by medium-thickness skin graft collected from homolateral outer thigh.Results All the flaps of 9patients survived.Two patients had necro- sis at the distal end of the flaps and were cured by changing dressing.One patient had tension blisters on the flap and was cured by removing blisters and improving mierocirculation.All patients were followed up for 3 months,and the flaps were good in blood supply,appearance,and color,with hypaesthesia.Conclusions Repair of small wounds with bone or steel plate exposure in anterior tibia by adjacent fascioeutaneous flap !s simple in surgical procedure and does not damage the well-known blood vessels,and the appearance,texture,and thickness of flaps are close to the skin of anterior tibia region.It is a good choice for repairing this kind of wounds and worth promoting in clinic.
作者
张永宏
沈国良
赵小瑜
钱汉根
黄春辉
徐军
范姝雯
Zhang Yonghong;Shen Guoliang;Zhao Xiaoyu;Qian Hangen;Huang Chunhui;Xu Jun;Fan Shuwen(Department of Burns and Plastic Surgery,the First Affiliated Hospital of Soochow University,Soochow 215006,China)
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2018年第12期907-909,共3页
Chinese Journal of Burns
关键词
伤口愈合
外科皮瓣
筋膜皮瓣
胫前区
Wound healing
Surgical flaps
Fascioeutaneous flap
Anterior tibia
