腹部带蒂皮瓣修复上肢大面积皮肤缺损

发布时间：2018-03-01 14:23

  本文关键词： 腹部带蒂皮瓣 穿支皮瓣 改良缝合 创面修复 上肢　出处：《中国修复重建外科杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨腹部带蒂皮瓣宽蒂部设计以及改良缝合方法修复上肢大面积皮肤缺损的可行性及疗效。方法 2014年3月—2016年8月,采用腹部带蒂皮瓣修复11例手部及前臂皮肤软组织缺损。男8例,女3例;年龄18~65岁,平均38岁。致伤原因:机器绞伤7例,交通事故伤4例。左上肢6例,右上肢5例。皮肤软组织缺损范围12 cm×7 cm~20 cm×10 cm。受伤至手术时间2~5 d,平均4 d。采用下腹部皮瓣修复4例,脐旁皮瓣修复7例。皮瓣切取范围10 cm×9 cm~22 cm×10 cm;皮瓣采用宽蒂部设计,蒂部宽8~18 cm,平均15 cm;蒂部行改良缝合。术后3周断蒂。结果术后皮瓣均成活,无淤血、坏死及张力性水疱发生;创面均Ⅰ期愈合。供区切口均Ⅰ期愈合。随访时间4~12个月,平均8个月。皮瓣色泽、质地、外形良好,皮瓣及供区均无溃疡形成。供区仅遗留线状瘢痕。结论腹部带蒂皮瓣进行宽蒂部设计并改良缝合,可减少腹部皮肤组织浪费,避免术后感染,且手术操作简便,固定牢靠,修复上肢大面积皮肤缺损可行。
[Abstract]:Objective to investigate the feasibility and curative effect of wide pedicle design of abdominal pedicle flap and modified suture method for repairing large area skin defect of upper limb. Methods from March 2014 to August 2016, Skin and soft tissue defects of hand and forearm were repaired with abdominal pedicled flap in 11 cases. Male 8 cases, female 3 cases, age 1865 years old, mean 38 years old. The causes of injury were: machine wound in 7 cases, traffic accident in 4 cases, left upper limb in 6 cases, left upper limb in 6 cases. There were 5 cases of right upper extremity. The area of skin soft tissue defect was 12 cm 脳 7 cm~20 cm 脳 10 cm. The average time from injury to operation was 2 days, 4 cases were repaired with lower abdominal flap and 7 cases with paracomphal flap. The area of skin flap was 10 cm 脳 9 cm~22 脳 10 cm, and the flap was designed with wide pedicle. The pedicle width was 8 ~ 18 cm (mean 15 cm). The pedicle was sutured with modified suture. The pedicle was broken 3 weeks after operation. Results the flap survived without congestion, necrosis and tension blisters, the wound healed in stage 鈪，

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