三种修复手部创面皮瓣的临床疗效评价

目的 比较骨间背侧动脉皮瓣、股前外侧皮瓣和腓肠内侧动脉穿支皮瓣的临床疗效,为临床的皮瓣选用提供参考.方法 对应用骨间背侧动脉皮瓣、股前外侧皮瓣和腓肠内侧动脉穿支皮瓣修复手部创面的23例患者进行随访,比较分析DASH(disability of the arm,shoulder and hand)分数、损伤的部位、触觉压觉(Senunes-Weinstein单丝法)、两点分辨觉(动、静态,m2PD、s2PD)、温度觉、臃肿程度和供区瘢痕挛缩程度.结果 三种皮瓣的DASH评分、瘢痕挛缩程度、皮瓣的臃肿程度、触觉压觉、两点分辨觉和温度觉的结果 ,差异均没有统计学意义;股前外侧皮瓣的臃肿程度高于其他两种皮瓣,差异具有统计学意义.结论 三种皮瓣各有特点,临床选择应该根据各种客观要求,不要主观臆测.

Three different flaps for coverage of soft tissue defects in the hand:a clinical evaluation

Objective To evaulate the clinical results of posterior interosseous artery flap, anterolateral thigh flap and medial sural artery perforator flap for coverage of soft tissue defects in the hand and to provide useful guidance on clinical selection of flaps. Methods Twenty-three cases with soft tissue defects of the hand repaired with these three different flaps were followed up and evaluated. DASH scores, touch and pressure (Semmes-Weinstein monofllament test), 2-point discrimination (motion 2PD and static 2PD), thermal sensation, flap bulkiness and donor site contracture were recorded and analyzed statistically. Results There were no significant differences in all detected data among these three different flaps, except for flap bulkiness. The transplanted anterolateral thigh flap was much bulkier than the other two flaps. Concldusion The posterior interesseous artery flap, anterolateral thigh flap and medial sural artery perforator flap have their own characteristics. Flap selection should be evideuce-based to suit individual case and clinical requirement.