本文選題：雙葉皮瓣 + 下腹部��； 參考：《蘇州大學(xué)》2015年碩士論文

【摘要】：目的探討應(yīng)用游離下腹部雙葉皮瓣一次修復(fù)手足部多個創(chuàng)面的方法和治療效果。方法對9例手足部多發(fā)創(chuàng)面,設(shè)計以旋髂淺動脈及腹壁淺動脈為蒂的雙葉皮瓣修復(fù),其中2例為足部創(chuàng)面(1例為前足1個脫套創(chuàng)面、另1例為2個創(chuàng)面),7例為手部創(chuàng)面(最多的為3個創(chuàng)面,最少的為2個創(chuàng)面)。皮膚缺損面積3.0cm×2.0cm~15.0cm×5.0cm。共切取皮瓣18塊,皮瓣切取面積6.0cm×3.0cm~19.0cm×7.0cm。結(jié)果本組9例雙葉皮瓣8例一期存活,1例皮瓣遠(yuǎn)端部分壞死經(jīng)換藥1月后瘢痕愈合。隨訪5~21月,平均10個月,皮瓣質(zhì)地優(yōu)良、4例外觀略顯臃腫、皮瓣恢復(fù)保護(hù)性感覺,2例修復(fù)足部者,術(shù)后行走活動不受限。7例修復(fù)手部者,5例手指伸屈活動良好,2例皮瓣邊緣出現(xiàn)疤痕攣縮影響手指背伸,經(jīng)二期疤痕改形后手指功能改善。腹部供區(qū)僅留線狀疤痕無不適感覺。結(jié)論游離下腹部雙葉皮瓣修復(fù)手足部創(chuàng)面,可一次手術(shù)完成多處皮膚缺損創(chuàng)面覆蓋,供區(qū)隱蔽、可直接縫合,是一種同時修復(fù)手足部多發(fā)創(chuàng)面的較理想方法。
[Abstract]:Objective to explore the method and therapeutic effect of free lower abdominal double-lobe flap in repairing multiple wounds of hand and foot.Methods bilateral flaps pedicled with superficial circumflex iliac artery and superficial abdominal artery were designed in 9 patients with multiple hand and foot wounds.The other 1 case was 2 wounds and 7 cases were hand wounds (3 wounds were the most and 2 wounds were the least).The area of skin defect was 3.0cm 脳 2.0cm~15.0cm 脳 5.0 cm.18 flaps were incised, and the area of the flaps was 6.0cm 脳 3.0cm~19.0cm 脳 7.0 cm.Results among 9 cases, 8 cases survived in one stage and 1 case had partial necrosis of the distal part of the flap, which healed after one month of dressing change.Follow-up for 5 ~ 21 months (mean 10 months) showed that the skin flap had a good texture in 4 cases with a slightly bloated appearance, and the skin flap recovered the protective sensation in 2 cases to repair the foot.After operation, 7 cases of hand repair were not restricted in walking movement, 5 cases had good finger extension and flexion activity, 2 cases had scar contracture on the edge of flap, and the finger function was improved after secondary scar reconstruction.There was no discomfort in the abdominal donor area with only linear scar.Conclusion the free lower abdominal bilobular flap is an ideal method for repairing hand and foot wounds with multiple skin defects covered by a single operation, the donor area is concealed and can be sutured directly, which is an ideal method for repairing multiple wounds of the hand and foot at the same time.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R658

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