创伤致皮肤软组织缺损的皮瓣修复

目的：进一步阐明带蒂皮瓣和游离皮瓣在创伤救治中的价值，总结应用中的经验体会。方法：对１９９１～１９９８年收治的创伤早晚期的住院病例进行分析总结。结果；本组２２８例需皮瓣修复的病例中用带蒂皮瓣修复１７６例，用游离皮瓣修复５２例，占同期创伤病例４６４例的４９．１％，常见的严重手部挫斯脱伤多应用以旋骼浅血管为蒂的骼腰部皮瓣和以腹壁下浅血管为蒂的下腹部皮瓣带蒂移植修复，在远位皮瓣中应用的比例较高（５０．０

Skin flap repair of soft traumatic tissue defect

AIM: To expound the value of pedicle and free flap for the repair of soft tissue injures, and to summarize the experiences. METHODS: To analyze the medical records of trauma in the plastic surgery center from 1991 to 1998. RESULTS: There were 228 patients whose soft tissue defects were repaired with skin flap include 176 pedicle flaps and 52 free flaps which mad up 49.1% of 464 cases of trauma. The superficial circumflex iliac flap and the superficial inferior epigastric flap were common pedicle flap donor sites for serious avulsion and crush injury of hand. In recent years, the subcutaneous tissue of the flaps was partially trimmed off and with use of subdermal vascular network skin flaps the results of repair is improved. Latissimas dorsi myocutaneous flap and anterolateral thigh flaps were common free flap donor sites. The advantages of these two free flaps were donor defects relatively acceptable and donor scar inconspicuous. Thorough debridement was very important for success of surgery. Anastomosis was the key point in surgery. The free skin flap could be transferred immediately or 1~3 days after debridement. CONCLUSION: Application of skin flaps, especially free flap, for the treatment of trauma can save limbs and reduce maims rate. There was no other technique can replace the free flap for the repair of soft tissue injury in some circumstances.