摘要
目的探讨腘窝中间动脉蒂混合供血皮瓣的血供特点及修复儿童腘窝瘢痕挛缩松解后创面的可行性。方法 2008年1月-2010年10月,对6例腘窝瘢痕挛缩患儿行瘢痕松解、腘窝中间动脉蒂混合供血皮瓣移位修复。男2例,女4例;年龄2岁2个月～10岁。均为热水烫伤。腘窝瘢痕挛缩松解后创面范围5 cm×4 cm～10 cm×8 cm,皮瓣切取范围6 cm×4 cm～11 cm×9 cm。供区直接缝合1例,游离植皮5例。结果术后6例患儿皮瓣完全成活,无血管危象或皮瓣坏死发生。供、受区切口均Ⅰ期愈合,供区植皮均成活。术后患儿均获随访,随访时间12～24个月,皮瓣色泽、质地、外形良好。1例患儿术后6个月腘窝手术切口出现较厚增生性瘢痕,膝关节活动范围0～175°,随访15个月无明显变化;余5例膝关节活动范围0～180°,无跛行。结论腘窝中间动脉蒂混合供血皮瓣血供可靠,手术操作简便,修复儿童腘窝瘢痕挛缩松解后创面效果理想。
Objective To investigate the characteristics of blood supply of popliteal fossa middle artery pedicled flaps and the feasibility of reconstruction of postburn popliteal fossa contractures using the flaps in children. Methods Between January 2008 and October 2010, 6 cases of postburn popliteal fossa contractures were recontructed using popliteal fossa middle artery pedicled flaps. Of them, 2 were boys and 4 were girls, aged from 2 years and 2 months to10 years. All burns were caused by hot water. The wound ranged from 5 cm × 4 cm to 10 cm × 8 cm after scar relaxation. The size of the flap ranged from 6 cm × 4 cm to 11 cm × 9 cm. Donor sites were covered with split-thickness skin graft in 5 cases, and sutured directly in 1 case. Results All the flaps and the skingraft survived; no vascular crisis or flap necrosis occurred. All incisions at donors and wounds healed by first intention. All patients were followed up 12-24 months. The color, texture, and appearance of the flaps were good. Hyperplastic scar was found at incision of popliteal fossa in 1 case at 6 months after operation; the range of motion （ROM） of the knee joint was 0-175°, and no obvious change was observed at 15 months after operation. The others had no functional disturbance of the knee joints or claudication; the ROM of the knee joint was 0-180°. Conclusion The popliteal fossa middle artery pedicled flap has reliable blood supply, simple operative procedure, and good results in reconstruction of popliteal fossa contracture.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2012年第8期946-949,共4页
Chinese Journal of Reparative and Reconstructive Surgery
基金
贵州省科技厅社会发展基金(黔科合SY字[2010]3060号)~~
关键词
腘窝中间动脉蒂混合供血皮瓣
腘窝瘢痕挛缩
创面修复
儿童
Popliteal fossa middle artery pedicled flap Popliteal fossa contracture Woundrepair Children
