中国组织工程研究

中国组织工程研究

• 细胞与组织移植 cell and tissue transplantation • 上一篇    下一篇

上肢微型游离皮瓣在手指创面修复中的应用

程建文1，谭桢2，王静威2，薛明强3，赵劲民   

  1. 广西医科大学第一附属医院创伤骨科手外科，南宁市 530021
  • 出版日期:2014-01-01 发布日期:2014-01-01
  • 作者简介:程建文，男，1979年生，广西柳州人，壮族，2003年广西医科大学毕业，在读博士，主治医师，研究方向：创伤外科手外科、组织工程

THE APPLICATION OF UPPER LIMB FREE MINI-FLAP TO REPAIR WOUNDS ON FINGERS

CHENG JIAN-WEN1，WANG JING-WEI2，XUE MIN-GQIANG，ZHAO JING-MIN1 ,TAN ZHEN2   

  1.  Department of TRAUMA AND ORTHOPEDIC, THE FIRST Affiliated Hospital of GUANGXI MEDICAL UNIVERSITY Nanning, Guangxi, 530021, P.R.China
  • Online:2014-01-01 Published:2014-01-01

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摘要：

背景：合并严重软组织并骨缺损的下肢开放性骨折，伤后胫前皮肤软组织坏死缺损，骨质、钢板外露等在临床上经常发生，关键在于坚强的骨折固定以及合理应用血供可靠的皮瓣封闭创面。
目的：探讨上肢微型游离皮瓣修复各种外伤所致手指创面的手术方法及近期疗效。
方法：2010年12月～2014年2月，收治12例（12指）手部不规则创面。男10例，女2例；年龄16～ 45岁，平均30岁。皆为手部外伤所致创面，病程7～ 25天，平均10天。拇指5例，食指3例，中指2例，环指1例，小指1例；均为不规则创面，伴不同程度骨骼及肌腱外露；创面范围为1.5cm × 2.0cm ～ 3.0cm × 4.5cm。12例均先行创面清创处理，之后采用四肢微型游离皮瓣修复创面；供区直接缝合。
结果与结论：12例皮瓣均成活，供区及受区切口皆Ⅰ期愈合。患者均获随访，随访时间3～6个月，平均4.5个月。皮瓣外观良好，无需再次行皮瓣修整，患指功能及外观恢复较理想。根据中华医学会手外科学会上肢部分功能评定试用标准评定患指术后活动功能[1]，获优3例，良8例，差1例。上肢微型游离皮瓣是修复手部创面的理想方法，具有对手部正常组织无损伤及供区隐蔽等优点。

关键词: 实验动物, 组织构建, 负压封闭引流, 腹股沟皮瓣, 游离移植, 大面积软组织缺损

Abstract:

BACKGROUND: Recently，the repair method of irregular wound on fingers primarily include local pedicled flap and free-mini-flap of upper extremities or lower extremities..
OBJECTIVE: To discuss the application of free-mini-flap derived from upper limb in repairing surface of wound on fingers.
METHODS: From December 2010 to February 2014, 12 patients were treated with irregular wounds on fingers, consisting of 10 males and 2 femals, from16-45 years (an average age of 30 years). All of them were injured by varied of trauma with a 7-25days course of disease (median 10 days). 5 of them were hurt in thumb, 3 were index finger, 2 were middle finger，the other 2 were ring finger and little finger respectively. The size of wounds ranged from 1.5 cm × 2.0 cm to 3.0 cm × 4.5cm with different degree of bone or tendon exposed. Predisposed of debridement, 12 patients were treated by diverse free mini-flaps of upper limb. The donor sites were made the first-period-sewing operation..
RESULTS AND CONCLUSION: Among the 12 patients, all of the wound of recipient and donor site healed at stage I, and the free mini-flags survival completely. All of patients have been followed up for 3-6 months (average 4.5 months). 12 free mini-flags have good appearance and needn’t undergo secondary trimming of flag. The active motion of fingers improved dominantly. Following the criterion of Hand Surgery Association Society of Chinese Medical Association Society standard for the part function evaluation trial-use of upper limb, 3 cases were in excellent, 8 were good, only 1 was bad. Free mini-flaps of upper limb is an ideal method for coverage of wounds on fingers. It is advantage to protect the health tissue remaining in hand and limit the hurt of donor site.

Key words: Free mini-flap, Finger Wounds, Repair