Zhang Ziyang, Tang Xiujun, Wei Zairong, Jin Wenhu, Wang Dali, Wang Bo, Deng Chengliang
Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P.R.China.
Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Sep 15;31(9):1102-1105. doi: 10.7507/1002-1892.201703099.
To investigate the feasibility and effectiveness of designing wide pedicle of abdominal pedicled flap and repairing large skin defect of upper limb with improved suture method.
Between March 2014 and August 2016, 11 cases with hand and forearm skin soft tissue defect were repaired with abdominal pedicled flaps. Among them, 8 cases were male and 3 were female; aged 18-65 years (mean, 38 years). The causes of injury were machinery injury in 7 cases and traffic accident in 4 cases. The wound located at left upper limb in 6 cases and right upper limb in 5 cases. The size of wound ranged from 12 cm×7 cm to 20 cm×10 cm. The interval from injury to operation was 2-5 days (mean, 4 days). Four cases were repaired with lower abdominal flap and 7 with umbilical flap. The size of flap ranged from 10 cm×9 cm to 22 cm×10 cm. And the flap was designed with wide pedicle at width of 8 to 18 cm (mean, 15 cm); then the wound was sutured with improved method. The pedicle was cut after 3 weeks.
All the flaps survived without congestion, necrosis, and tension blisters. The wound and the incision were both healed at stage Ⅰ. All patients were followed up 4-12 months (mean, 8 months). The skin color, texture, and shape were satisfying, and no ulcer formed. Only line-like scar left at the donor site.
Abdominal pedicled flap with wide pedicle and improved suture method can reduce the abdominal skin waste, avoid postoperative infection, and be feasible to repair large skin defect of upper limb with advantages of simple operation and reliable fixation.
探讨设计腹部带蒂皮瓣宽蒂并采用改良缝合方法修复上肢大面积皮肤缺损的可行性及有效性。
2014年3月至2016年8月，采用腹部带蒂皮瓣修复11例手部及前臂皮肤软组织缺损患者。其中男8例，女3例；年龄18 - 65岁（平均38岁）。致伤原因：机器伤7例，交通事故伤4例。伤口位于左上肢6例，右上肢5例。创面大小为12 cm×7 cm至20 cm×10 cm。受伤至手术间隔时间为2 - 5天（平均4天）。下腹壁皮瓣修复4例，脐旁皮瓣修复7例。皮瓣大小为10 cm×9 cm至22 cm×10 cm。设计宽蒂皮瓣，蒂宽8至18 cm（平均15 cm）；然后采用改良方法缝合创面。3周后断蒂。
所有皮瓣均成活，无淤血、坏死及张力性水疱形成。创面及切口均Ⅰ期愈合。所有患者随访4至12个月（平均8个月）。皮肤颜色、质地及外形满意，无溃疡形成。供区仅留线状瘢痕。
采用宽蒂腹部带蒂皮瓣及改良缝合方法可减少腹部皮肤浪费，避免术后感染，修复上肢大面积皮肤缺损可行，且手术操作简单、固定可靠。
