游离下腹部双叶皮瓣修复手足部多发创面的临床研究

发布时间：2018-04-12 05:57

本文选题：双叶皮瓣 + 下腹部　；参考：《苏州大学》2015年硕士论文

【摘要】：目的探讨应用游离下腹部双叶皮瓣一次修复手足部多个创面的方法和治疗效果。方法对9例手足部多发创面,设计以旋髂浅动脉及腹壁浅动脉为蒂的双叶皮瓣修复,其中2例为足部创面(1例为前足1个脱套创面、另1例为2个创面),7例为手部创面(最多的为3个创面,最少的为2个创面)。皮肤缺损面积3.0cm×2.0cm~15.0cm×5.0cm。共切取皮瓣18块,皮瓣切取面积6.0cm×3.0cm~19.0cm×7.0cm。结果本组9例双叶皮瓣8例一期存活,1例皮瓣远端部分坏死经换药1月后瘢痕愈合。随访5~21月,平均10个月,皮瓣质地优良、4例外观略显臃肿、皮瓣恢复保护性感觉,2例修复足部者,术后行走活动不受限。7例修复手部者,5例手指伸屈活动良好,2例皮瓣边缘出现疤痕挛缩影响手指背伸,经二期疤痕改形后手指功能改善。腹部供区仅留线状疤痕无不适感觉。结论游离下腹部双叶皮瓣修复手足部创面,可一次手术完成多处皮肤缺损创面覆盖,供区隐蔽、可直接缝合,是一种同时修复手足部多发创面的较理想方法。
[Abstract]:Objective to explore the method and therapeutic effect of free lower abdominal double-lobe flap in repairing multiple wounds of hand and foot.Methods bilateral flaps pedicled with superficial circumflex iliac artery and superficial abdominal artery were designed in 9 patients with multiple hand and foot wounds.The other 1 case was 2 wounds and 7 cases were hand wounds (3 wounds were the most and 2 wounds were the least).The area of skin defect was 3.0cm 脳 2.0cm~15.0cm 脳 5.0 cm.18 flaps were incised, and the area of the flaps was 6.0cm 脳 3.0cm~19.0cm 脳 7.0 cm.Results among 9 cases, 8 cases survived in one stage and 1 case had partial necrosis of the distal part of the flap, which healed after one month of dressing change.Follow-up for 5 ~ 21 months (mean 10 months) showed that the skin flap had a good texture in 4 cases with a slightly bloated appearance, and the skin flap recovered the protective sensation in 2 cases to repair the foot.After operation, 7 cases of hand repair were not restricted in walking movement, 5 cases had good finger extension and flexion activity, 2 cases had scar contracture on the edge of flap, and the finger function was improved after secondary scar reconstruction.There was no discomfort in the abdominal donor area with only linear scar.Conclusion the free lower abdominal bilobular flap is an ideal method for repairing hand and foot wounds with multiple skin defects covered by a single operation, the donor area is concealed and can be sutured directly, which is an ideal method for repairing multiple wounds of the hand and foot at the same time.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R658

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