阔筋膜瓣移植修复手背软组织缺损

目的:采用吻合血管的阔筋膜瓣移植修复手背软组织缺损,观察其临床应用效果。方法:修复12例(男8例,女4例)手背软组织缺损;右手7例,左手5例;年龄16~46岁(平均30岁)。缺损范围4 cm×6 cm~8 cm×15 cm,切取阔筋膜瓣范围5.0 cm×7.5 cm~8 cm×16 cm。行Ⅰ期中厚网状游离植皮,供区直接缝合,阔筋膜瓣的血管蒂与受区的血管行端端吻合。结果:1例术后发生远端尖部小片植皮坏死,经更换敷料逐渐自行愈合。11例术后经过顺利,全部成活,取得了满意的临床效果。结论:该筋膜瓣以旋股外侧动脉降支为血供,血运丰富,血管解剖恒定,血管蒂长以及切取容易,而且较薄,适宜修复手背软组织缺损。

Repair of soft tissue defects of the dorsum of hands with fascia lata flaps

Objective: To study clinical application of fascia lata flaps for the repair of soft tissue defects of the dorsum of hands by using microvascular anastomoses.Methods: Twelve patients(8 male and 4 female,ranging in age from 16 to 46 years,with an average of 30 years) with soft tissue defects of the dorsum of hands underwent reconstruction operation with fascia lata flaps by using microvascular anastomoses.Among the patients,7 patients had defects in right hands and 5 patients had the defects in left hands.Soft tissue defects ranged from 4 cm×6 cm to 8 cm×15 cm,and the fascia lata flaps ranged from 5.0 cm×7.5 cm to 8 cm×16 cm.The immediate coverage of the fascia lata flaps were performed by a meshed split-thickness skin graft.The thigh donor site was closed directly.The vascular pedicle of the flaps were anastomosed end-to-end to recipient site vascular.Results: One flap developed minor necrosis at the distal tip of skin graft and the wound gradually healed after daily wound dressing.Eleven flaps had survived completely without major complications and with satisfactory clinical results.There was no remarkable donor site morbidity.Conclusion: The fascia lata flap is nourished by the descending branch of the lateral circumflex femoral artery.The flap is highly vascularized,with a constant vascular anatomy and a long vascular pedicle,so that dissection of the flap could be accomplished easily.The flap is thin and suitable for the repair of soft tissue defects of the dorsum of hands.