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皮瓣移植术后的二期修复

The Secondary Plastic Operation after Skin Flap Grafting
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摘要 目的 探讨皮瓣、肌皮瓣移植后二期整形之手术时机、手术适应症、手术方式选择及疗效评价。方法 对 4 96例皮瓣、肌皮瓣移植术后的患者实施二期整形手术 ,采用皮瓣一侧及中线等手术切口 ,部分同时行肌腱、神经移植、肌腱松解、关节矫形手术及取出内固定器。结果 患肢 (指 )功能明显改善 ,皮瓣区和正常皮肤基本在一个平面 ,无明显疤痕为满意 ,占 6 7% ;患肢 (指 )功能、皮瓣臃肿情况有较大改善为基本满意 ,占 2 9.8% ;出现切口边缘皮肤坏死 ,需再次行皮缺损修复术 ,占 3.2 %。结论 皮瓣、肌皮瓣移植术后的二期整形 ,应根据不同患者的不同要求、移植修复的不同部位、皮瓣的大小 ,采取不同的手术切口及手术方式。皮下组织去除后皮瓣长度不应超过 6cm ,超过 6cm者 ,则应保留部分结蒂组织和皮瓣相连。多组织损伤 ,应以恢复肢 (指 )体功能为主。 Objective To explore the operation opportunity of secondary plastic operation after skin flap grafting and musculacutaneous flap grafting, indication of operation, choice of operation way and comment of therapeutic. Methods To operate secondary plastic operation on 469 patients who are operated skin flap grafting and musculacutaneous flap grafting.Use incision of one side and centerline, to execute the operation of tendon and nervous grafting and myotendolysis and joint orthopedics and to take out the materials of internal fixation.Results It is satisfaction that there is obviousy improvability of wounded limbs or wounded fingers and flap area is generally in the same surface with the normal skin area, and without obvious scar, occupied 67%. It is generic satisfaction that there is improvability or wounded limbs of wounded fingers and overstaffed of flaps, occupied 29.8%. Necrosis of border of skin and need secondary skin grafting, occupied 3.2%. Conclusion The secondary plastic operation of skin flap grafting and musculacutaneous grafting is based on the different request of different patients and different areas, and different size of flaps, operated with different incision and operation method . The length of skin flap shouldn’t extend 6cm after cut off the subscutaneous tissue, or we would partly reserve subcutaneous tissue that connecting with skin flap to those over 6 cm. If more tissue injured, to repair function of wounded limbs or wounded fingers is more important.
出处 《医药论坛杂志》 2004年第23期5-6,共2页 Journal of Medical Forum
关键词 皮瓣移植 二期 整形手术 Skin flap grafting Second stage Plastic surgery
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