游离异形股前外侧皮瓣在手外科的临床应用.pdf

·827·ChineseJournalofReparativeandReconstructiveSurgery,2006,Vol20(7)
游离异形股前外侧皮瓣在手外科的临床应用

施海峰芮永军寿奎水张全荣孙振中邱扬程涛

【摘要】目的介绍一种一期修复手部不同区域、不同面积皮肤缺损的方法。方法2002年5月～2004年
5月,设计不同形状的股前外侧皮瓣和股前外侧分瓣(二者组合为异形股前外侧皮瓣),修复手外科创伤中多发性多部位
的皮肤缺损27例,其中男16例,女11例。左手9例,右手16例,左足2例。洞穿伤致手掌、背皮肤缺损5例,热压伤9例,
齿轮伤6例,梳毛机伤5例,碾压伤致左足背、足底皮肤缺损2例,均伴有肌腱或骨、关节外露。采用“H”形皮瓣修复手掌贯
穿伤5例,“Y”形或“K”形皮瓣修复手掌背伴手指皮肤缺损11例;“3”形皮瓣修复手背伴手掌侧方或虎口皮肤缺损3例,
足背伴足底皮肤缺损2例,“h”形皮瓣修复手背伴与之不相连的手指皮肤缺损6例。主瓣范围为615cm×418cm～1710
cm×1210cm,分瓣为315cm×218cm～715cm×415cm。结果术后27例皮瓣全部成活,除1例筋膜瓣以外皮瓣受
区伤口均É期愈合,无血管危象发生。均获随访3～12个月,外形满意,皮瓣质地柔软。除2例洞穿伤、3例热压伤及1例
梳毛机伤患者手功能恢复不理想,其余患者均恢复抓、捏功能,12个月以上患者恢复触、痛觉,两点辨别觉114～215cm。
结论异形股前外侧皮瓣是修复手部复杂皮肤缺损较为理想的方法。
【关键词】异形股前外侧皮瓣游离移植多发性手损伤修复
中图分类号:R658.2R622.1文献标识码:A

CLINICALAPPLICATIONOFIRREGULARANTERIORLATERALFEMORALFLAPINHANDSURGERYöSHI
Haifeng,RUIYongjun,SHOUKuishui,etal.WuxiHandSurgeryHospital,WuxiJiangsu,214061,P.R.China
Correspondingauthor:SHIHaifeng,E2mail:[e-mail]
【Abstract】ObjectiveTointroduceamethodtorepairsofttissuedefectindifferentregionsanddifferentareas
ofhandinoneprocedure.MethodsFromMay2002toMay2005,anterolateralfemoralflaporlobulatedanterolateral
femoralflap(formingirregularanterolateralfemoralflap)wasdesignedintodifferentshapestorepairmultiplesofttissue
defectindifferentregionsinhand,whichwasusedclinicallyin27cases.Among27cases,therewere16malesand11
females;thelocationswerelefthandin9,righthandin16andleftfootin2;including5penetratinginjury,9
hotpressinginjury,2softtissuedefectionofinstepandplantabymilledinjury,6gearinginjuryand5cardingmachine
injury.Allthecasescomplicatedbyexposureoftendons,bonesorjoints.DefectwasrepairedwithH2shapeflapsin
5casesofpenetratingpalminjuries;withY2shapeorK2shapeflapsin11casesofdorsalsorcombinedwithfingersof
handwithskindefect;with32shapeflapsin3casesofdorsalscombinedwithsidesofpalmsorthefirstwebofhands
withskindefectandin2casesofskindefectsofdorsalscombinedwithpalmsoffeet;withh2shapeflapsin6casesof
skindefectsofdorsalorpalmscombinedwithdisconnectedskindefectoffingers.Thes