筋膜蒂皮瓣和腹部带蒂皮瓣修复手指皮肤软组织缺损的对比分析

目的 分析对比用筋膜蒂皮瓣与腹部带蒂皮瓣修复手指皮肤软组织缺损的临床疗效.方法 选取我院2008年5月至2014年3月期间收治的手指皮肤软组织缺损致肌腱、血管、神经、骨质裸露的180例患者,将其随机分为两组,每组各90例.两组分别采用筋膜蒂皮瓣修复和腹部带蒂皮瓣修复手指皮肤软组织缺损.观察两组的临床疗效.结果 术后172例皮瓣成活良好,筋膜蒂皮瓣坏死5例,腹部带蒂皮瓣坏死3例,成活的皮瓣伤口愈合佳.全部患者术后3～12个月随访,筋膜蒂皮瓣术后患指耐寒程度、整体外观、屈伸功能、耐磨性及感觉恢复情况都较腹部带蒂皮瓣好（P＜0.05）,8例坏死皮瓣经换药、植皮愈合良好.结论 用筋膜蒂皮瓣修复手指皮肤软组织缺损的综合疗效优于腹部带蒂皮瓣.

Comparative Analysis of Fascial Pedicle Flap and Abdominal Pedicle Flap in Repairing Soft Tissure Defect of Finger Skin

Objective To compare and analyse the clinical effect of fascia pedicle flap and abdominal pedicle flap in repairing soft tissue defect of finger skin. Methods 180 eases of patients with exposed tendons, blood vessels, nerve and bone caused by finger skin soft tissue defect treated in our hospital from May 2008 to March 2014 were selected and randomly divided into two groups, with 90 cases in each group. The two groups were given fascial pedicle flap and abdominal pedicle flap to repair finger skin soft tissue defect respectively. The clinical effects of two groups were observed and compared. Results 172 cases of flaps survival were good after operation, 5 cases of fascia pedicle flap were necrosis, 3 cases of abdominal pedicle flap were necrosis, the survival flap wound healed well. All patients received follow-up visit after 3 - 12 months of the operation, the cold resistance, overall appearance, flexion and extension function, abrasive resistance and sensory recovery of the fascia pedicle flap surgery were better than those of the abdominal pedicle flap （P 〈0.05）, 8 cases of necrosis skin flap healed well after dressing change and skin graft. Conclusions The comprehensive curative effect of the fascia pediele skin flap is better than that of the abdominal pedicle skin flap in repairing finger skin soft tissue defect.