Suppr超能文献

[双叶型腓浅动脉穿支皮瓣修复手指相邻双创面的效果]

[Effects of bilobated superficial peroneal artery perforator flap in repairing two adjacent wounds of the fingers].

作者信息

Zhang T, Cheng J N, Yang L, Sun F W, Gao Q F, Huang Y T, Yang C P, Cao Y, Liu Z J, Ju J H

机构信息

Department of Hand Surgery, Suzhou Ruihua Orthopaedic Hospital, Suzhou 215104, China.

出版信息

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Jul 20;39(7):655-661. doi: 10.3760/cma.j.cn501225-20220930-00428.

Abstract

To investigate the therapeutic efficacy of bilobated superficial peroneal artery perforator flap in repairing two adjacent wounds of the fingers. A retrospective observational study was conducted. From January 2021 to January 2022, 15 patients with two adjacent wounds of the fingers who met the inclusion criteria were hospitalized in Suzhou Ruihua Orthopaedic Hospital, including 10 males and 5 females, aged 25 to 51 years. The area of single wound after debridement was from 2.5 cm×2.0 cm to 7.5 cm×2.5 cm. All the wounds were repaired by the bilobated superficial peroneal artery perforator flap from the lower leg. The single lobe area of bilobated flap was from 3.0 cm×2.0 cm to 8.0 cm×3.0 cm. The wounds in all the donor sites were sutured directly. During the operation, the number of resected flaps, the number and type of carried perforators were recorded, and the calibers of perforator and superficial peroneal artery and the length of vascular pedicle were measured. The survival of flap and the wound healing in the donor and recipient sites were recorded after operation. The recovery of donor and recipient sites were recorded during follow-up. At the last follow-up, the repair effect of flap was evaluated by the comprehensive evaluation scale, and the sensory function of flap was evaluated by the sensory function evaluation standard of British Medical Research Association. During the operation, 15 bilobated flaps were successfully resected, carrying 36 superficial peroneal artery perforators, all of which were septocutaneous perforators with the caliber of 0.2-0.8 mm. The caliber of superficial peroneal artery was 0.4-1.1 mm and the length of vascular pedicle was 3-8 cm. After operation, all the flaps survived with no vascular crisis occurred, and the wounds in donor and recipient sites healed well. During the follow-up of 6 to 12 months, the color and texture of flaps were similar to those of normal tissue in the hand and the appearance of flap was good in 10 cases; the other 5 cases underwent the stage Ⅱ flap thinning and plastic surgery 6 months after operation due to the bloated appearance of flaps. There was only linear scar in the donor site of lower leg, with no obvious scar hyperplasia or pigmentation, and there was no obvious adverse effect on the sensation or motor function of the distal limbs in the donor area. At the last follow-up, the repair effect of flap of 15 patients was excellent in 11 cases and good in 4 cases, and the sensory function of the flap was evaluated as grade S in all cases. The bilobated superficial peroneal artery perforator flap has high proportion of septocutaneous perforator, and the blood supply is sufficient and reliable. Using this flap to repair two adjacent wounds of the fingers causes minimal damage to the donor area, only one group of blood vessels is needed to be anastomosed to repair two wounds, the difficulty of microoperation is reduced, and good flap repair effect and sensory function can be obtained.

摘要

探讨双叶型腓浅动脉穿支皮瓣修复手指相邻双创面的治疗效果。进行一项回顾性观察研究。2021年1月至2022年1月,苏州瑞华骨科医院收治符合纳入标准的手指相邻双创面患者15例,其中男10例,女5例,年龄25~51岁。清创后单创面面积为2.5 cm×2.0 cm至7.5 cm×2.5 cm。所有创面均采用小腿双叶型腓浅动脉穿支皮瓣修复。双叶皮瓣单叶面积为3.0 cm×2.0 cm至8.0 cm×3.0 cm。所有供区创面均直接缝合。术中记录切取皮瓣数量、携带穿支数量及类型,测量穿支、腓浅动脉管径及血管蒂长度。术后记录皮瓣存活及供、受区创面愈合情况。随访期间记录供、受区恢复情况。末次随访时,采用综合评价量表评估皮瓣修复效果,采用英国医学研究协会感觉功能评价标准评估皮瓣感觉功能。术中成功切取15个双叶皮瓣,携带36支腓浅动脉穿支,均为肌间隔皮穿支,管径0.2~0.8 mm。腓浅动脉管径0.4~1.1 mm,血管蒂长度3~8 cm。术后皮瓣全部存活,未发生血管危象,供、受区创面愈合良好。随访6~12个月,10例皮瓣颜色、质地与手部正常组织相似,外观良好;另5例术后6个月因皮瓣臃肿行Ⅱ期皮瓣修薄整形手术。小腿供区仅留线性瘢痕,无明显瘢痕增生及色素沉着,对供区远端肢体感觉及运动功能无明显不良影响。末次随访时,15例患者皮瓣修复效果优11例,良4例,皮瓣感觉功能均评定为S级。双叶型腓浅动脉穿支皮瓣肌间隔皮穿支比例高,血供充足可靠。采用该皮瓣修复手指相邻双创面,对供区损伤小,修复两个创面仅需吻合一组血管,减少了显微手术难度,可获得良好的皮瓣修复效果及感觉功能。

相似文献

1
[Effects of bilobated superficial peroneal artery perforator flap in repairing two adjacent wounds of the fingers].
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Jul 20;39(7):655-661. doi: 10.3760/cma.j.cn501225-20220930-00428.
2
[Curative effects of the superficial peroneal artery perforator flap carrying multiple perforators in repairing hand and foot wounds].
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Mar 20;39(3):234-240. doi: 10.3760/cma.j.cn501225-20220723-00305.
3
[Clinical effects of free superficial peroneal artery perforator flaps in repairing skin and soft tissue defects of the hallux].
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022 Aug 20;38(8):753-758. doi: 10.3760/cma.j.cn501120-20210604-00211.
4
[Effects of free superficial peroneal artery perforator flap in repairing small and medium-sized thermal crush injury wounds in the hand].
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Jun 20;39(6):546-551. doi: 10.3760/cma.j.cn501225-20220623-00256.
6
[Clinical application of lobulated transplantation of free anterolateral thigh perforator flap in the treatment of electric burns of limbs].
Zhonghua Shao Shang Za Zhi. 2019 Nov 20;35(11):790-797. doi: 10.3760/cma.j.issn.1009-2587.2019.11.005.
7
[Multiple free homologous superficial peroneal artery perforator flaps of crus for repair of multiple hand wounds].
Zhonghua Shao Shang Za Zhi. 2019 Sep 20;35(9):655-660. doi: 10.3760/cma.j.issn.1009-2587.2019.09.003.
8
[Clinical effects of different types of tissue flaps in repairing the wounds with steel plate exposure and infection after proximal tibial fracture surgery].
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Dec 20;39(12):1140-1148. doi: 10.3760/cma.j.cn501225-20231101-00171.
9
[Effects of miniature free groin perforator flaps in repairing small wounds on hands].
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Oct 20;39(10):933-938. doi: 10.3760/cma.j.cn501225-20230701-00244.
10
[Clinical effects of anterolateral thigh perforator flap with sensory nerves in repairing the plantar skin and soft tissue defects].
Zhonghua Shao Shang Za Zhi. 2021 May 20;37(5):453-459. doi: 10.3760/cma.j.cn501120-20200309-00136.

本文引用的文献

1
Oromandibular reconstruction with double-skin paddle fibular free flap: A systematic review and meta-analysis.
Microsurgery. 2021 Oct;41(7):676-687. doi: 10.1002/micr.30786. Epub 2021 Jul 6.
2
Superficial peroneal nerve accessory artery (SPNAA) flap for head and neck reconstruction: A cadaveric anatomical study and retrospective case series review.
J Plast Reconstr Aesthet Surg. 2021 Jul;74(7):1524-1533. doi: 10.1016/j.bjps.2020.11.012. Epub 2020 Nov 22.
3
[Clinical application of lobulated transplantation of free anterolateral thigh perforator flap in the treatment of electric burns of limbs].
Zhonghua Shao Shang Za Zhi. 2019 Nov 20;35(11):790-797. doi: 10.3760/cma.j.issn.1009-2587.2019.11.005.
4
Use of medial upper arm free flap in oral cavity reconstruction: a preliminary study.
Int J Oral Maxillofac Surg. 2018 May;47(5):595-602. doi: 10.1016/j.ijom.2017.12.008. Epub 2018 Feb 1.
5
6
Prospective series of reconstruction of complex composite mandibulectomy defects with double island free fibula flap.
J Surg Oncol. 2017 Aug;116(2):258-262. doi: 10.1002/jso.24647. Epub 2017 Apr 18.
7
Free multilobed posterior interosseous artery perforator flap for multi-finger skin defect reconstruction.
J Plast Reconstr Aesthet Surg. 2015 Jan;68(1):9-16. doi: 10.1016/j.bjps.2014.08.063. Epub 2014 Sep 6.
8
Vascular anatomy and clinical application of anterolateral leg perforator flaps.
Plast Reconstr Surg. 2013 Apr;131(4):534e-543e. doi: 10.1097/PRS.0b013e3182827675.
9
Anatomical study and colour Doppler assessment of the skin perforators of the anterior tibial artery and possible clinical applications.
J Plast Reconstr Aesthet Surg. 2009 Nov;62(11):1524-9. doi: 10.1016/j.bjps.2008.06.013. Epub 2008 Aug 13.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验