游离尺动脉腕上穿支皮瓣修复手指软组织缺损的临床应用
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作者Author单位AddressE-Mail
汤样华 TANG Yang-hua 杭州市萧山区中医院手外科, 浙江 杭州 311201 Department of Hand Surgery, Xiaoshan TCM Hospital, Hangzhou 311201, Hangzhou, China tangyanghua168@sohu.com 
曾林如 ZENG Lin-ru 杭州市萧山区中医院手外科, 浙江 杭州 311201 Department of Hand Surgery, Xiaoshan TCM Hospital, Hangzhou 311201, Hangzhou, China  
黄忠名 HUANG Zhong-ming 杭州市萧山区中医院手外科, 浙江 杭州 311201 Department of Hand Surgery, Xiaoshan TCM Hospital, Hangzhou 311201, Hangzhou, China  
岳振双 YUE Zhen-shuang 杭州市萧山区中医院手外科, 浙江 杭州 311201 Department of Hand Surgery, Xiaoshan TCM Hospital, Hangzhou 311201, Hangzhou, China  
徐灿达 XU Can-da 杭州市萧山区中医院手外科, 浙江 杭州 311201 Department of Hand Surgery, Xiaoshan TCM Hospital, Hangzhou 311201, Hangzhou, China  
辛大伟 XIN Da-wei 杭州市萧山区中医院手外科, 浙江 杭州 311201 Department of Hand Surgery, Xiaoshan TCM Hospital, Hangzhou 311201, Hangzhou, China  
期刊信息:《中国骨伤》2014年,第27卷,第9期,第778-780页
DOI:10.3969/j.issn.1003-0034.2014.09.016
基金项目:
中文摘要:

目的:探讨游离尺动脉腕上穿支皮瓣修复手指软组织缺损的方法及临床效果。

方法:2010年2月至2012年12月,应用游离尺动脉腕上穿支皮瓣修复手指软组织缺损16例,男10例,女6例;年龄18~52岁,平均38.2岁。热压伤5例,机器挤压伤8例,鞭炮炸伤3例。缺损面积:1.3 cm×2.3 cm~2.6 cm×5.0 cm.皮瓣切取面积:1.5 cm×2.5 cm~2.8 cm×5.2 cm.观察皮瓣外形及两点分辨觉。

结果:术后皮瓣全部存活,伤口均Ⅰ期愈合,供受区没有 并发伤口感染及皮肤坏死。前臂供区直接缝合11例,游离植皮5例。所有病例获随访,时间6~24个月,平均10.8个月,皮瓣外观不臃肿,质地色泽接近受区,皮瓣感觉恢复良好,两点分辨觉为6~9 mm.供区外形较好,无明显功能障碍,伴轻度瘢痕形成。

结论:游离尺动脉腕上穿支皮瓣具有血管解剖恒定、厚薄适中、带感觉神经等优点,是修复手指软组织缺损的有效方法。
【关键词】外科皮瓣  修复外科手术  软组织损伤  手损伤
 
Clinical application of free vascularized flaps based on the wrist cutaneous branch of ulnar artery in repairing finger soft tissue defect
ABSTRACT  

Objective: To investigate the methods and clinical effects of repairing finger soft tissue defect with free vascularized flaps based on the wrist cutaneous branch of ulnar artery.

Methods: From February 2010 to December 2012, 16 patients with finger soft tissue defects were repaired by free vascularized flaps based on the wrist cutaneous branch of ulnar artery, including 10 males and 6 females with an average age of 38.2 years old ranging from 18 to 52 years. Among them, 5 cases caused by hot crush injury, 8 cases caused by machine crush injury, 3 cases caused by firecracker burst injury. The defect area varied from 1.3 cm×2.3 cm to 2.6 cm×5.0 cm. The flap area varied from 1.5 cm×2.5 cm to 2.8 cm×5.2 cm. The appearance and two-point discrimination of flap were observed after operation.

Results: All flaps survived and wounds healed primarily. No wound infection and skin necrosis were found in donor site and recipient site. Among repair methods, direct suture in forearm donor site had 11 cases and skin graft had 5 cases. All patients were followed up from 6 to 24 months with an average of 10.8 months. The appearance of flap was not fat or clumsy, texture and color were similar to the recipient site, the sensation were good, two-point discrimination was 6 to 9 mm. The appearance of donor site were well complicated with mild scarring without dysfunction obviously.

Conclusion: The free vascularized flaps based on the wrist cutaneous branch of ulnar artery has the advantages of vascular anatomy constant, thickness moderate and carry sensory nerves, etc, which is effective way to repair finger soft tissue defects.
KEY WORDS  Surgical flaps  Reconstructive surgical procedures  Soft tissue injuries  Hand injuries
 
引用本文,请按以下格式著录参考文献:
中文格式:汤样华,曾林如,黄忠名,岳振双,徐灿达,辛大伟.游离尺动脉腕上穿支皮瓣修复手指软组织缺损的临床应用[J].中国骨伤,2014,27(9):778~780
英文格式:TANG Yang-hua,ZENG Lin-ru,HUANG Zhong-ming,YUE Zhen-shuang,XU Can-da,XIN Da-wei.Clinical application of free vascularized flaps based on the wrist cutaneous branch of ulnar artery in repairing finger soft tissue defect[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(9):778~780
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