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游离上臂外侧穿支皮瓣修复手足部电烧伤创面 被引量:14

Repair of wound on hand or foot due to electrical burn using free lateral upper arm perforator flap
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摘要 目的观察游离上臂外侧穿支皮瓣修复手足部电烧伤创面的效果。方法2010年6月-2013年6月,笔者单位收治手足部Ⅲ度电烧伤患者6例,创面大小:6.0cm×4.0cm-8.5cm×7.5cm。采用游离上臂外侧穿支皮瓣修复创面,皮瓣面积为9cm×4cm-12cm×9cm。5例供区拉拢缝合,1例供区移植腹部全厚皮。结果1例中指受损患者术后因皮瓣静脉回流障碍坏死,经换药后取腹部全厚皮移植修复;其余5例皮瓣全部成活,皮瓣颜色和弹性与受区较匹配,臃肿不明显。随访6—24个月,手足部功能恢复尚可,5例患者手功能评定结果:优2例、良2例、差1例。供瓣区瘢痕较轻,无明显功能障碍,效果较佳。结论游离上臂外侧穿支皮瓣血管蒂相对较长,脂肪组织较少,是修复手足部电烧伤小创面的较佳皮瓣。 Objective To observe the effect of free lateral upper arm perforator flap in repairing wound on hand or foot due to electrical burn. Methods Six patients with full-thickness wounds on hand or foot resulting from electrical burn were hospitalized from June 2010 to June 2013. The wounds ranged from 6.0 cm× 4.0 cm to 8.5 cm × 7.5 cm in area. Free lateral upper arm perforator flaps were used to repair these defects, with flap area ranging from 9 cm ×4 cm to 12 cm ×9 cm. The donor sites in five cases were closed by suturing; the other one donor site was closed by transplantation of full-thickness skin from abdo- men. Results One flap used to repair the wound in middle finger failed due to failure of venous return, and it was repaired with full-thickness skin harvested from abdomen after dressing change. The other five flaps survived resulting in good elasticity and matched appearance of the recipient area without obvious bulki- ness. Patients were fallowed up for 6 to 24 months. The function of the injured hands or feet recovered well, and the results of function evaluation of five hands were excellent in 2 cases, good in 2 cases, and poor in 1 case. Little scar formation with no contraction or function impairment was observed on donor site, and the re- sult was satisfactory. Conclusions Free lateral upper arm perforator flap, with long vessel and less adi- pose tissue, is suitable for repairing small but deep wound on hand or foot due to electrical burn.
出处 《中华烧伤杂志》 CAS CSCD 北大核心 2013年第5期424-426,共3页 Chinese Journal of Burns
关键词 烧伤 外科皮瓣 创面修复 Burns, electric Hand Foot Surgical flaps Wound repair
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