部分削薄的游离脐旁皮瓣修复手部皮肤缺损

目的：研究修复手部大面积或不规则形状皮肤缺损的一种技术。方法：设计类似Ｙ、和Ｔ等形状的游离脐旁皮瓣，采用了部分削薄皮瓣、端侧吻合动脉和联合移植等技术手段。结果：临床应用１１例，成活１０例，效果良好。结论：部分削薄的脐旁皮瓣可改善美观效果，供皮面积大。血管蒂长达１５ｃｍ以上，口径粗，供区多可直接缝闭，是覆盖复杂手部创面的有效方法。

FREE VASCULARIZED THINNED SKIN FLAP BASED ON INFERIOR EPIGASTRIC ARTERY FOR REPAIRING HAND SKIN DEFECT

Objective:To study a type of available method a large area or irregular skin defect of hands,Methods:There were 9 male and 2 female in eleven patients with complex skin defect on the hand,ranged in age from 4 to 28years (mean 22 years and 3 months).Different shaped free vascularized thoracic-umbilical skin flaps based on inferior epigastric a rtery were designed to cover the complex skin defects of hands in 11 patients,The thinned size of each flap was from 30%to 75%(mean 40%).Three of the flaps were used in combined transplantation with other free flaps,The end-to-side arterial anastomosis were used in 7 cases.Results:Ten of the flaps survived , and one whose thinned size was 75% failed because of destruction of the vein system in the flap.All patients were follwed-up for a average of 15 months(ranged from 4 to 37 months).The final functional and cosmetic results are satisfactory. Conclusions:Our results showed that this type of flap is a valid method for repair of complicated skin defect of hands.If the skin defect of a hand can not be covered by the simple methods,the free thinned thoracic-umbilical flap based on inferior epigastric artery should be considered as first choice.