游离足背皮瓣移植修复手背软组织缺损的临床分析

Clinical analysis of free dorsal pedis flap graft in dorsal hand soft tissue defect repair

关键词:  游离皮瓣  组织缺损  修复手术  足背  移植

Key words:  free flap  tissue defect  surgery repair  dorsal pedis  graft

摘要:

目的　探讨应用游离足背皮瓣修复手背部软组织缺损的适应证及临床疗效。　方法　自2013年3月至2015年11月在潍坊医学院附属医院骨外科，采用吻合血管的游离足背皮瓣移植修复手背部软组织缺损25例，其中一期急诊行游离足背皮瓣修复19例，一期清创封闭负压引流(vacuum-sealing drainage，VSD)，二期游离足背皮瓣修复6例。术后观察皮瓣成活情况及并发症。随访1~2年，观察皮瓣外观及皮瓣两点的分辨觉。　结果　术后皮瓣全部成活，术后平均随访1.3年，皮瓣质地较薄，弹性适中，感觉恢复良好，两点辨别觉为4~7 mm。　结论　采用游离足背皮瓣移植修复手背软组织缺损临床效果确切，是一种理想的方法。

Abstract:

Objective　 To explore the indications and clinical curative effect of free dorsal pedis flap in repairing dorsal hand soft tissue defect.　Methods　 From March 2013 to November 2015,in the Department of bone surgery at Affiliated Hospital of Weifang Medical University, 25 cases received free dorsal pedis flap graft to supply vascular anastomosis and repair the dorsal hand soft tissue defect.One stage emergency line free flap repair was performed in 19 cases.First phase of debridement and closed negative pressure drainage (drainage VSD, vacuum-sealing) followed by second phase free dorsal foot flap repair was performed in 6 cases.　Results　 All free flaps survived after surgery.During one to two years of follow up, flaps had skin texture, moderate elasticity and two-point discrimination for 4-7 mm.　Conclusion　 Free dorsal pedis flap is a good method to repair soft tissue defects of dorsal hand.