摘要
目的分析对比穿支皮瓣与游离皮瓣修复手部及前臂皮肤缺损的疗效。方法回顾性分析平顶山市第一人民医院创伤显微外科2020年1月至2022年12月收治的82例手部及前臂皮肤缺损患者临床资料,其中选择接受游离皮瓣修复的41例患者为游离组,选择接受穿支皮瓣修复的41例患者为穿支组。比较两组患者手部及前臂功能恢复情况、创面愈合时间、修复疗效、并发症发生率及感觉修复状况。结果穿支组术后手指总主动活动度(TAM)高于游离组,明尼苏达手灵巧度测试(MMDT)相关试验耗时均短于游离组,差异有统计学意义(P<0.05)。穿支组术后Fugl-Meyer评定量表上肢部分(FMA-UE)、手臂动作调查测试(ARAT)得分均高于游离组,其创面愈合时间显著短于游离组,差异有统计学意义(P<0.05)。穿支组修复有效率高于游离组,差异有统计学意义(P<0.05)。穿支组并发症发生率明显低于游离组,差异有统计学意义(P<0.05)。穿支组感觉修复达到S3的人数占比高于游离组,差异有统计学意义(P<0.05)。结论与游离皮瓣相比,穿支皮瓣对手部及前臂皮肤缺损患者功能及感觉的修复效果更为显著,创面愈合时间更短,并发症更少、安全可靠。
Objective To compare the clinical efficacy of perforator flap and free skin flap in the repair of hand and forearm skin defects.Methods Clinical data about 82 hand and forearm skin defects patients admitted to the trauma microsurgery department of the First People's Hospital of Pingdingshan from January 2020 to December 2022 were retrospectively analyzed.Among them,41 cases of taking the free skin flap were set as free group,41 cases of taking the perforator flap were set as perforator group.The hand and forearm function recovery conditions,wound healing time,repair effects,surgical complications and skin sensation repair conditions were compared between two groups.Results The total active motion(TAM)values in perforator group were higher than free group;Minnesota manual dexterity test(MMDT)test completion time in perforator group were significantly shorter than free group,with significant differences(P<0.05);After surgery,Fugl-Meyer Assessment-Upper Extremity(FMA-UE)and action research arm test(ARAT)scores in perforator group were significantly higher than free group;the wound healing time was shorter than free group,with significant differences(P<0.05);The total repair rate in perforator group was significantly higher than free group,with significant difference(P<0.05);The surgical complication rate in perforator group was significantly lower than free group,with significant difference(P<0.05);The proportion of the perforators with sensory repair reaching S3 in perforator group was significantly higher than free group,with significant difference(P<0.05).Conclusion Compared with the free flap,the perforator flap has a more significant repair effect on the function and sensation of the patients with skin defects of the hand and forearm.The wound healing time is shorter,the complications are less,and it is safe and reliable.
作者
韩国坡
杨新乐
康阳阳
HAN Guopo;YANG Xinle;KANG Yangyang(Department of Trauma Microsurgery,Pingdingshan First People’s Hospital,Pingdingshan Henan 467000,China)
出处
《临床研究》
2023年第5期51-54,共4页
Clinical Research
关键词
穿支皮瓣
游离皮瓣
手部
前臂
皮肤缺损
修复
perforator flap
free skin flap
hand
forearm
skin defects
repair
