腹部双蒂真皮下血管网皮瓣修复手部脱套伤

目的　总结腹部双血管蒂真皮下血管网皮瓣急诊修复手部脱套伤的效果。方法1994年～1997 年对19 例手部脱套伤,急诊采用腹壁下动脉为蒂的薄皮瓣和腹壁浅动脉为蒂的薄皮瓣进行瓦合修复。结果　术后皮瓣全部成活。随访1～3年,手外形美观,皮瓣质地柔韧,伸指正常,拇指对掌功能正常。掌指关节屈曲45°～60°,近指节关节屈曲10°～25°,生活自理。结论　采用腹部双血管蒂真皮下血管网皮瓣修复手部脱套伤具有皮瓣移位后血循环好,抗感染力强,成活率高,修复后手外形美观,不臃肿等特点。

ABDOMINAL BIPEDICLED SUBEPIDERMAL VASCULAR-NETWORK FLAP IN REPAIR OF DEGLOVING INJURY OF HAND

Objective To evaluate the clinical result of repairing degloving injury of hand with abdominal bipedicled subdermal vascular network flap in emergence.Methods From 1994 to 1997, 19 cases with degloving injury of hand were treated with two flaps, one flaps with the inferior epigastric artery as pedicle, another with superficial epigastric artery. The two skin flaps were designed oppositely to cover the injured hands.Results All the flaps survived.Followed up for 1 to 3 years, the contour of hands were fine. Extension of fingers was normal and opponers of thumbs was good. Range of flexion of metacarpo phalangeal joints was from 45 to 60 degree, and the proximal interphalangeal joints was from 10 to 25 degree.Conclusion For the subdermal vascular network, the bipedicled flaps of abdomen in repair of degloving injury of hand have sufficient blood supply, strong resistance to infection, high survival rate,and good contour.