腓肠内侧动脉穿支皮瓣游离移植修复重度虎口瘢痕挛缩
陈彦名;唐举玉;谢松林;刘鸣江;夏晓丹;邓翔午
【期刊名称】《中华手外科杂志》 【年(卷),期】2017(033)003
【摘要】目的 探讨腓肠内侧动脉穿支皮瓣治疗重度虎口瘢痕挛缩的临床疗效.方法 自2012年10月至2015年3月,对14例重度虎口瘢痕挛缩患者行瘢痕切除、虎口开大后,采用腓肠内侧动脉穿支皮瓣移植修复,皮瓣切取面积为5cm ×4cm～9cm× 6cm,术后通过观察皮瓣外形、感觉恢复情况、虎口张开角度、虎口宽度以及供区恢复情况评估其疗效.结果 14例皮瓣全部存活,虎口饱满,外形满意,无继发挛缩,供区创面Ⅰ期愈合.术后随访时间12～18个月(平均14个月),术前虎口张开角度(15±5)°、术后(80±6)°,术前宽度(20.0±3.5) mm、术后(45.0±5.6)mm.拇指的外展、内收及对掌功能明显改善.术后皮瓣均恢复了保护性感觉,其中6例缝合腓肠内侧皮神经的感觉恢复到S3.供区肢体活动无影响.结论 腓肠内侧动脉穿支皮瓣穿支较为恒定,修复虎口外形满意,供区创伤小,是一种修复重度虎口挛缩的有效方法.%Objective To explore the clinical effect of free medial sural artery perforator (MSAP)flap for repair of severe thumb web scar contracture.Methods From October 2012 to March 2015,14 cases of severe thumb web scar contracture were repaired with free MSAP flap after scar excision.The flap areas ranged from 5 cm×4 cm to 9 cm×6 cm.The clinical outcomes were evaluated by the appearance of transplanted flaps,sensory recovery,opening angle and width of thumb web and donor site recovery at postoperative follow-
up.Results All 14 flaps survived uneventfully.The thumb webs were wellstacked with satisfactory shapes.There was no secondary contracture.Primary healing was achieved at donor sites.Postoperative follow-up ranged from 12 to 18 months,with an average of 14 months.Postoperative angle of repaired thumb webs was enlarged to (80±6)° from preoperative angle of (15±5)°.And the width was enlarged to (45.0±5.6) mm from (20.0±3.5) mm.Thumb functions of abduction,adduction and opposition were all improved obviously.All flaps restored protective sensation.Six cases with anastomosis of medial sural cutaneous nerve recovered to S3.No functional damage was observed at donor sites.Conclusion MSAP flap is an effective way to repair severe thumb web contracture because of its constant perforator,satisfactory shape of repaired thumb webs and minor damages to donor sites. 【总页数】3页(190-192)
【关键词】外科皮瓣;移植;腓肠内侧动脉穿支;虎口挛缩 【作者】陈彦名;唐举玉;谢松林;刘鸣江;夏晓丹;邓翔午
【作者单位】421002湖南衡阳,南华大学附属南华医院手足外科;长沙,中南大学湘雅医院骨科;421002湖南衡阳,南华大学附属南华医院手足外科;421002湖南衡阳,南华大学附属南华医院手足外科;421002湖南衡阳,南华大学附属南华医院手足外科;421002湖南衡阳,南华大学附属南华医院手足外科 【正文语种】中文
【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-hand-surgery_thesis/0201234669540.html 【相关文献】
1.腓肠内侧动脉穿支皮瓣修复小腿中上段皮肤缺损的临床分析 [J], 陈泽群; 王荣春; 银春景; 陈拓; 郭伟峰
2.游离腓肠内侧动脉穿支皮瓣修复手部创面 [J], 张龙春; 陈莹; 王鹏; 丁晟; 马亮; 姚建民
3.游离腓肠内侧动脉穿支皮瓣修复头颈部缺损的初步研究 [J], 毛驰; 张雷; 崔秋菊; 彭歆; 王洋; 俞光岩
4.腓肠内侧动脉穿支游离皮瓣修复手、足创面24例的报告 [J], 王兆庆; 杜顺雷; 戴国光
5.腓肠内侧动脉穿支肌皮瓣游离移植修复骨髓炎创面的效果观察(附19例报告) [J], 李小磊; 林光豪; 陈芝武; 魏鹏; 郭明君
以上内容为文献基本信息，获取文献全文请下载
腓肠内侧动脉穿支皮瓣游离移植修复重度虎口瘢痕挛缩
