双侧胸脐带蒂皮瓣联合修复前臂及手部两处软组织缺损

目的探讨应用双侧胸脐皮瓣修复前臂及手部两处软组织缺损的可行性。方法1997年8月至2000年5月，对7例前臂及手部两处大面积软组织缺损患者，采用双侧胸脐带蒂皮瓣顺、逆行联合移位修复创面。皮瓣面积为10cm～12cm×10cm～28cm。7例皮瓣后期均经断蒂训练,一般于术后5至6周断蒂。结果术后所有皮瓣均全部成活。1例的逆行胸脐皮瓣于术后24h,远端皮缘呈青紫色，经拆除部分缝线后血运恢复正常；术后2周游离局部皮下组织后将皮瓣与创缘直接拉拢缝合。7例患者术后前臂和手部外观良好，为二期手术创造了良好的软组织条件。结论双侧顺、逆行胸脐皮瓣的最佳适应证为一期修复前臂及手部创面两处软组织缺损的创面。

Repair of soft tissue defects at forearm and hand with double thoracic-umbilical flaps

Objective To investigate practicality to repair two soft tissuedefects at forearm and hand with double thoracic-umbilical flaps. Methods Seven cases of major area soft tissue defects at forearm and hand were involved from August 1997 to May 2000. The wound was covered emergently with double thoracic-umbilical flaps anterogradely and retrogradely, with the area of flap 10 ～ 12cm × 10 ～ 28 cm. The vascular pedicle was wrapped at late stage and the pedicle was cut 5 ～ 6 weeks postoperatively. Results All the flaps were survived with satisfactory results. In one case, blue purple color in the distal flap appeared at postoperative 24 hour. The blood supply was restored normally after partial stitch removal, then direct suture was done between the wound and flap at postoperative 2 weeks. All cases obtained satisfactory appearance at forearm and hand, thus healthy soft tissue was provided for secondary operation. Conclusions Double thoracic-umbilical flap was an optimal indication for two soft tissue defects at the forearm and hand at the first stage repair.