摘要
目的探讨应用旋髂浅动脉游离皮瓣修复手指背侧软组织缺损的临床疗效。方法自2010年9月至2015年10月，我们采用旋髂浅动脉游离皮瓣修复拇、手指背侧软组织缺损创面21例。均为手指背侧皮肤软组织缺损，缺损范围2．5cm×3．0cm～3．0cm×5．5cm。均有不同程度骨或肌腱外露，伴指骨骨折2例，合并骨质及伸肌腱缺损3例。切取皮瓣范围3．0cm×3．5cm～3．5cm×5．5cm，供区直接缝合。结果术后皮瓣全部存活，1例出现张力性水泡，经局部拆线后逐渐好转，顺利存活。所有患者皮瓣及供区创面均Ⅰ期愈合。其中5例术后3个月因皮瓣臃肿再次行皮瓣削薄术，术后外形满意。术后随访时间为6～18个月，平均11个月。皮瓣质地、弹性良好，外观饱满。末次随访时手功能按中华医学会手外科学会上肢部分功能评定试用标准评定：优16例，良4例，可1例。皮瓣两点分辨觉为8～13mm，平均9mm。结论应用旋髂浅动脉游离皮瓣修复手指背侧软组织缺损，供区隐蔽损伤小，不增加手指医源性创伤，是修复手指背侧较大面积缺损的有效方法。
Objective To evaluate the efficacy of free transfer of superficial iliac circumflex artery flap in coveting dorsal soft tissue defects of the thumb and fingers. Methods From September 2010 to October 2015, 21 cases of soft tissue defects in the dorsal aspect of the thumb and fingers were treated with free transfer of the superficial iliac circumflex artery flap. The size of the soft tissue defects ranged from 2.5 cm×3.0 cm to 3.0 cm×5.5 cm. All the cases had different degrees of bone or tendon exposure, with phalangeal fracture in 2 cases and bone and extensor tendon defects in 3 cases. The size of the flaps harvested ranged from 3.0 cm×3.5 cm to 3.5 cm×5.5 cm. The donor sites were closed directly. Results All the flaps survived after the operation. Tension blister occurred in 1 case, and the flap survived after decompression with stitch removal. Primary healing was obtained in the recipient sites and the donor sites in all cases. Secondary de- bulky surgery was performed in 5 cases 3 month after the flap transfer which achieved the good flap appearance. Postoperative follow-up period ranged from 6 to 18 months, the average time being 11 months. All the flaps survived with fine texture, elasticity and aesthetics. According to the functional evaluation standards issued by Hand Surgery Society of the Chinese Medical Association, the results were excellent in 16 cases, good in 4 cases, and fair in 1 case. The two-point discrimination ranged from 8 to 13mm, with the average being 9 mm. Conclusion Free superficial iliac circumflex artery flap transfer is an effective procedure to repair soft tissue defects on the dorsal side of the thumb and fingers with the excellent function and appearance and minor donor site morbidity.
出处
《中华手外科杂志》
CSCD
北大核心
2017年第2期98-100,共3页
Chinese Journal of Hand Surgery
关键词
指损伤
外科皮瓣
旋髂浅动脉
软组织缺损
Finger injuries
Surgical flaps
Superficial iliac circumflex artery
Soft tissue defect
