【摘要】 目的探讨改良游离下腹部穿支皮瓣修复手部创面的临床应用效果。方法采用以腹壁浅动脉、旋髂浅动脉为蒂的深筋膜穿支皮瓣修复手部创面43例。其中以旋髂浅动脉为蒂的皮瓣修复20例,以腹壁浅动脉为蒂的皮瓣修复23例。皮瓣面积8cm×5cm～22cm×11cm。观察术后皮瓣成活情况。结果术后42例皮瓣全部成活,1例皮瓣术后坏死,经换药后瘢痕化愈合,不影响手部功能。所有皮瓣经4～18个月(平均10个月)随访,皮瓣质地外形优良,手功能恢复满意。术后供区伤口均一期愈合,外形满意。结论应用改良的游离下腹部穿支皮瓣修复移植修复手部创面,克服血管变异、口径小等不足,皮瓣成活率显著提高,是一种较好的方法。更多还原

【Abstract】 Objective To evaluate the efficacy of modified hand reconstruction using deep inferior epigastric artery perforator flaps. Methods Hand reconstruction was performed for 43 cases with hand injury using deep inferior epigastric artery perforator flaps pedicled with the superficial epigastric artery and superficial circumflex iliac artery. Twenty cases were reconstructed using flaps pedicled with the superficial circumflex iliac artery,the other 23 using those pedicled with the superficial epigastric artery,and the flap area was 8 cm × 5 cm ～ 22 cm× 11 cm. Results The flaps of all 42 cases survived. The flaps survived 12 days after the surgery and the patients were discharged. The 4-to 18-month(average 10 months) follow-up showed favorable skin texture and shape with satisfactory hand function recovery. Primary healing was achieved in all the donor sites with acceptable appearance. Conclusions The modified hand reconstruction using deep inferior epigastric artery perforator flaps is an effective approach that significantly elevates flap survival rates,and is much less dependent on vessel variability and limited caliber.更多还原