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游离削薄股前外侧皮瓣修复手腕部软组织缺损
Hand and wrist reconstruction using free thinning anterolateral thigh flap
【摘要】 目的 探讨游离削薄型股前外侧皮瓣修复手腕部较大面积软组织缺损的临床效果。 方法 首先对手腕部创面控制感染,减少分泌物,术中彻底清创,对受区血管状况做出判断,保证吻合血管质量,其次切取股前外侧皮瓣后,断蒂前修薄皮瓣至浅筋膜层,一般保留穿支血管周围 1 .5~2 .0cm血管袖组织,可仅保留1支穿支血管。皮瓣移植修复创面后密切观察血供,及时处理血管危象。 结果 临床应用19例,移植皮瓣均成活,其中 2 例手术后 24 h出现血液循环危象,经及时处理后恢复皮瓣血液循环。 结论 削薄型股前外侧皮瓣厚度适宜,供区隐蔽,简便实用,可用于手腕部创面缺损修复,尤其适用于较大面积及肌腱、血管、神经外露创面的修复。
【Abstract】 Objective To present a method of free thinning anterolateral thigh flap in the reconstruction of the hand and wrist defects. Methods After controlling the wound infection, the anastomosed vessels were estimated and ensured to be in good quality during debridement. The flap was elevated and thinned to superficial fascia. Only 1.5~2.0 cm of the deep fascia attached to the cutaneous perforator was preserved. The remaining deep fascia and subdermal tissue were excised. The vascular crisis of the flaps should be observed carefully after transplantation. Results The result was satisfactory, all flaps were survived. Conclusion The anterolateral thigh flap is suitable for coverage of defects in the hand wrist regions, especially for defects with exposure of important tissue that require a relatively large flap.[
【Key words】 Anterolateral thigh flap; Hand; Wrist; Soft tissue defect; Microsurgery;
- 【文献出处】 中华显微外科杂志 ,Chinese Journal of Microsurgery , 编辑部邮箱 ,2005年01期
- 【分类号】R658
- 【被引频次】56
- 【下载频次】213