摘要
目的:探讨游离带肌腱的尺动脉腕上掌侧穿支皮瓣修复指背复合组织缺损中的临床效果。方法:选择2016年4月~2017年3月入院治疗的指背复合组织缺损患者58例,所有患者入院后均完善相关检查,采用随机数字表法分为对照组(n=20)和观察组(n=38)。对照组给予筋膜皮瓣修复,观察组均采用游离带肌腱的尺动脉腕上掌侧穿支皮瓣修复,手术后1周观察皮瓣的存活规律、动静脉危象发生情况及处理方法与原则。手术后对患者进行12个月随访,比较两组修复效果。结果:观察组治疗效果良好率高于对照组(P<0.05);观察组治疗后动脉危象、皮瓣发生水泡、发紫及皮瓣坏死率、完全坏死率均低于对照组(P<0.05);观察组术后进行12个月随访,皮瓣色泽红润,质地软,未见明显臃肿,指间关节活动好;对于坏死的组织进行切除,并重新进行植皮修复。结论:将游离带肌腱的尺动脉腕上掌侧穿支皮瓣用于指背复合组织缺损患者中能获得良好的修复效果,供受区外观良好,不会对屈腕功能产生影响,值得推广应用。
Objective:To explore the clinical effect of repair of compound tissue defect of dorsal finger with palmar perforator flap of upper wrist of ulnar artery of free band tendon.Methods:58 patients with compound tissue defect of dorsal finger treated in a hospital from April 2016 to March 2017 were selected and divided into the control group(n=20) and the observation group(n=38) by random number table method,and all patients completed the relevant examination after admission.The control group was given fascial skin flap repair,and the observation group was repaired with palmar perforator flap of upper wrist of ulnar artery of free band tendon. The survival pattern of the skin flap,the occurrence of arteriovenous crisis,and the treatment method and principle were observed at 1 week after surgery.Patients were followed up for 12 months after surgery to compare the repair effect of the two groups. Results:The rate of good curative effect in the observation group was higher than that in the control group(P<0.05).The arterial crisis,vesicle formation of skin flap,purple skin flap and necrosis rate of skin flap,and complete necrosis rate in the observation group after treatment were lower than those in the control group after treatment(P<0.05).The observation group was followed up for 12 months after surgery. The skin flap was ruddy and soft with no obvious bloat,and the interphalangeal joint was active. The necrotic tissue was resected and the necrotic tissue was repaired by skin graft. Conclusion:The application of the palmar perforator flap of upper wrist of ulnar artery of free band tendon can obtain a good repair effect in the patients with compound tissue defect of dorsal finger,and the appearance of the recipient area is good,and it will not affect the wrist flexor function,so it is worthy of promotion and application.
作者
朱海成
杨安
肖水军
Zhu Haicheng;Yang An;Xiao Shuijun(Department of Hand-foot Surgery and Plastic Surgery,Dongguan Third Bureau Hospital,Dongguan 523000)
出处
《数理医药学杂志》
2019年第10期1443-1445,共3页
Journal of Mathematical Medicine
关键词
游离带肌腱
尺动脉腕上掌侧穿支皮瓣
指背复合组织缺损
free band tendon
palmar perforator flap of upper wrist of ulnar artery
compound tissue defect of dorsal finger
