腹部双叶长蒂保留真皮下血管网皮瓣修复手部软组织缺损

摘要

Objective To summarize the clinical effects of long and double-pedicle abdominal flaps with preserved subcutaneous vascular network in the treatment of soft tissue defect of the hand. Meth-ods Eight cases of hand soft tissue defects were treated with long and double-pedicle abdominal flaps with preserved subcutaneous vascular network. According to defect size,flaps were designed for repair. Re-sults One patient′s pedicles were divided 3 weeks after the operation and distal edge necrosis occurred 5 days later. The wound was healed after dress changing. The other 7 patients′pedicles were divided 25 days after the operation and all flaps survived with primary healing. Six cases were followed up for 3 to 5 months. The flaps had good color and appearance. According to the ATM scoring system for hand function, the results were excellent in 3 cases,good in 3 cases and fair in 2 cases. The good and excellent rate was 75. 0%. Conclusion Long and double-pedicle abdominal flaps with preserved subcutaneous vascular net-work have the advantages of simple operation,easy nursing and alleviated pain,which are ideal for hand soft tissue defects.%目的：总结腹部双叶长蒂保留真皮下血管网皮瓣修复手部软组织缺损的临床效果。方法采用腹部双叶长蒂保留真皮下血管网皮瓣修复8例手部软组织缺损患者。根据软组织缺损面积大小，术中设计腹部双叶长蒂保留真皮下血管网皮瓣修复缺损。结果1例术后3周断蒂，断蒂术后5 d皮瓣远端边缘部分坏死，经换药后愈合；7例术后25d断蒂，皮瓣均顺利成活，伤口Ⅰ期愈合。腹部供区Ⅰ期愈合。6例术后获随访，随访时间3~5个月。皮瓣颜色、外形恢复基本满意，手功能按ATM标准评分：优3例，良3例，中2例，优良率75.0％。结论腹部双叶长蒂真皮下血管网皮瓣具有手术操作简便、术后便于护理、减轻患者痛苦等优点，是修复手部软组织缺损的理想方法之一。