【摘要】 目的 探讨大面积上肢皮肤软组织缺损修复的理想方法。方法 对本组13例上肢大面积皮肤软组织缺损的患者,分别联合应用预扩张的带蒂肩胛区皮瓣、背阔肌肌皮瓣、单侧或双侧脐旁皮瓣进行修复。结果 术后13例患者的皮瓣全部成活。其中,1例术后脐旁皮瓣和1例术后肩胛皮瓣的远端出现静脉回流不畅,经皮瓣表皮针刺放血和按摩处理后,静脉回流良好,皮瓣成活;有8例患者在术后远期进行了皮瓣去脂修薄及切口瘢痕整形术,使治疗效果趋于完善。结论 对于经过选择的择期手术患者,根据情况联合应用多个预扩张带蒂轴型皮瓣修复上肢大面积皮肤软组织缺损,是一个值得考虑的治疗方法。更多还原

【Abstract】 Objective To explore an optimal reconstructive modality for reconstruction of the extensive defect of the upper extremity.Methods Thirteen patients with extensive upper extremity defect were treated with different combinations of four workhorse pedicle flaps including the circumflex scapular artery-based flap,paraumbilical flap,and latissimus dorgi musculocutaneous flap.Results All of the flaps survived completely after the surgery.Venous congestion of the distal portion of the flap occurred in one paraumbilical flap and one scapular flap which extended far beyond the back midline.These flaps were treated with pinching for bleeding and massage and venous congestion faded gradually without any flap loss.Secondary procedures such as flap debulking and scar revision were performed for 8 patients to improve the aesthetic outcome further.Conclusion For selective operated patients,reconstruction of the extensive upper extremity defect by multiple pre-expanded pedicle axial flaps might be an optional method.更多还原