摘要
目的 探讨设计利用筋膜组织蒂连续性拼接的股前外侧分叶皮瓣修复手足部不规则创面的疗效。方法 2018年1月-2022年4月,根据四肢创面形状特点,探查穿支进入皮瓣并追踪穿支分支,设计、调整皮瓣原长度,旋转筋膜蒂组合皮瓣覆盖创面7例。创面大小:6 cm×11 cm~14 cm×16 cm,供区直接缝合。结果 术后7例皮瓣全部成活,其中1例出现旋转筋膜蒂皮瓣远端部分坏死,经换药愈合。7例均获6~24个月随访,平均14个月,皮瓣颜色及外观良好,无瘢痕及臃肿,大腿供区线性瘢痕。皮瓣两点辨别觉4~10 mm。结论 通过设计、结合受区形状特点进行裁剪、切取、组合的股前外侧分叶皮瓣,可以实现个体化的修复,利用筋膜组织的弹性牵张调整重建手足部不规则创面,提高了皮瓣成活率,避免组织浪费,同时有效减轻了供区损伤。
Objective To discuss the efficacy of"lobular"flap with fascia pedicle continuous splicing flap in repairing irregular wounds of hands and feet in the design of free anterolateral thigh flap for repairing complex cross-limb wounds.Methods From January 2018 to April 2022,according to the shape characteristics of the wound surface of the limbs,the perforator branch into the flap was explored and tracked.The original length of the flap was designed and adjusted,and the combined flap with the fascia pedicle was rotated to cover the wound surface.Wound size:6.0 cm×11.0 cm~14.0 cm×16.0 cm,direct suture at donor area.Results All 7 cases of skin flap survived.Partial necrosis of the distal end of the rotary fascia pedicle flap was observed in 1 case,which healed after dressing change.All patients were followed up for 6-24 months,with an average of 14 months.After operation,the skin flap had good color and appearance,no scar or swelling,linear scar in the donor area of the thigh.The two-point discernment of the flap was 4.0~10.0 mm.Conclusion Through the design,combined with the shape characteristics of the receiving area,tailoring,cutting and improvement of the combined flap can achieve individualized repair.The elastic stretching of fascia tissue is used to reconstruct the irregular wound of hands and feet,which improves the survival rate of skin flap,avoides tissue waste,and effectively reduces the donor area injury.
作者
周福成
吕永源
何智阔
樊雪鹏
赵胡瑞
ZHOU Fucheng;LV Yongyuan;HE Zhikuo(Department of Hand and Foot Microsurgery,The Third People's Hospital of Xinjinag Uygur Autonomous Region,Urumqi,Xinjinag Uygur Autonomous Region,830091,China)
出处
《实用手外科杂志》
2023年第4期467-469,474,共4页
Journal of Practical Hand Surgery
关键词
分叶
皮瓣
股前外侧皮瓣
不规则创面
Lobulation
Flap
Anterolateral femoral flap
Irregular wound
