摘要
目的探讨皮瓣、肌皮瓣移植后整形之手术时机、手术适应症、手术方式选择及疗效评价。方法对496例皮瓣、肌皮瓣移植术后的患者实施整形手术,采用皮瓣一侧及中线等手术切口,部分病例同时行肌腱、神经移植、肌腱松解、关节矫形手术及取出内固定器。结果患肢(指)功能明显改善,皮瓣区和正常皮肤基本在一个平面,无明显疤痕为满意,占67%;患肢(指)功能、皮瓣臃肿情况有较大改善为基本满意,占29.8%;出现切口边缘皮肤坏死,需再次行皮缺损修复术,占3.2%。结论皮瓣、肌皮瓣移植术后的二期整形,应根据不同患者的不同要求、移植修复的不同部位、皮瓣的大小,采取不同的手术切口及手术方式。皮下组织去除后皮瓣长度不应超过6cm,超过6cm者,则应保留部分结蒂组织和皮瓣相连。多组织损伤,应以恢复肢(指)体功能为主。
Objective: To explore the operation opportunity of secondary plastic operation after skin flap grafting and musculacutaneous flap grafting, indication of operation. Operation way and comment of therapeutic. Methods: Operate secondary plastic operation for 469 patients who are operated skin flap grafting and musculacutaneous flap grafting. Use incision of one side and centerline. Then execute the operation of tenden and nervous grafting and myotendolysis and joint orthopedics and to take out the materials of internal fixation. Results: It is satisfactory that there is obviously improvability of wounded limbs or wounded fingers and flap area is generally in the same surface with the normal skin area, and without obvious scar, occupied 67%. There is improvability or wounded limbs or wounded fingers and overstaffed of flaps, which occupied 29.8%. Necrosis of border of skin and need secondary skin grafting, which occupied 3.2%. Conclusions: The secondary plastic operation of skin flap grafting and musculacutaneous grafting is based on the different request of different patients and different areas, where are repaired with flaps and different size of flaps. It is operated with different incision and method of operated. The length of skin flap shouldn′t extend to 6 cm after cut off the subscutaneous tissue, or subcutaneous tissue that connecting with skin flap would be partly reserved. If more tissue injured, to repair function of wounded limbs or wounded fingers is more important for several injury of tissues.
出处
《中国医学工程》
2004年第5期92-93,96,共3页
China Medical Engineering
