摘要
目的探讨应用上臂外侧游离皮瓣修复重度虎口瘢痕挛缩的临床疗效。方法彻底切除虎口处瘢痕并松解粘连后，取同侧或对侧上臂外侧的皮肤筋膜组织瓣，带桡侧副动脉血管蒂束行游离移植，于受区背侧鼻烟窝处与桡动脉吻合，头静脉吻合，供区游离皮瓣移植或直接缝合，并用弓形针同定拇指于外展、对掌位。自2004年10月至2009年11月，以此法进行虎口修复手术16例。结果本组16例患者，除1例远端部分坏死，余者术后皮瓣全部成活。经12～18个月随访，虎口宽度平均增加32mm，虎口角度平均增加51°，两点辨别觉平均7mm，效果满意。结论应用上臂外侧游离皮瓣修复重度虎口瘢痕挛缩，可兼顾术后外形、皮肤质地及功能，是一种较好的手术方法。
Objective To explore the clinical effect of free graft of lateral upper ann skin flap for repairing severe scar contracture of the thumb web. Methods After the scar contracture removed clearly with thumb web opened, ipsilateral or contralateral arm free flap with vascular pediele was designed to repair the thumb web defect. The radial collateral artery was sutured to the radial artery and the radial collateral vein to the cephalic vein. The donor site was sutured directly or covered by free grafted skin. The thumb was fixed in abducens and opposite palm of hand position using an arch form pin. From October 2004 to November 2009, totally 16 pa- tients were received in this study. Results All flaps survived in 16 cases except 1 case with distal partly necrosis. After 12 to 18 months follow-up, the width of thumb web was augmented an average of 32 mm, thumb web angle was augmented an average of 51 degrees, and the average two-point discrimination was 7 ram. Conclusion Lateral arm free flap is an optimal method for the repair of severe eontraeture of thumb web which could obtain good function and satisfactory appearance.
出处
《中国美容整形外科杂志》
CAS
2011年第6期357-359,共3页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
上臂外侧皮瓣
游离移植
虎口
瘢痕挛缩
Lateral upper arm flap
Free graft
Thumb web
Scar contractures
