以筋膜皮下组织为蒂的筋膜皮瓣在修复四肢创面中的应用

目的 研究以筋膜皮下组织为蒂的筋膜皮瓣修复各种四肢创面的临床效果及优点.方法 采用以深筋膜及其皮下组织为蒂的筋膜皮瓣修复四肢创面共40例,其中软组织毁损性伤32例,肿瘤切除后创面5例(皮肤鳞癌3例、烧伤后瘢痕恶变的鳞癌2例),高压电击伤创面3例,皮瓣面积2 cm×4 cm.～4 cm×12 cm,通过随诊观察外形及功能恢复情况,评价疗效.结果 40例筋膜皮瓣中33例完全存活良好,6例出现部分坏死,经换药延期愈合.l例皮瓣皮肤层完全坏死,但皮下组织尚存活,经换药、植皮二期愈合.术后对25例进行随访2月～1年,术后创面覆盖满意,远期皮瓣色泽、弹性均好,外形及功能恢复满意.结论 以筋膜皮下组织为蒂的筋膜皮瓣切取方便,供区创伤小,转移灵活,血供丰富,抗感染能力强,适合修复四肢中小面积的创面.

Clinical application of fasciocutaneous flap with subcutaneous tissue pedicle in repairing wounds of extremities

OBJECTIVE To study the effects and advantages of fasciocutaneous flap with subcutaneous tissue pedicle in repairing various wounds of extremities.METHODS Used fasciocutaneous flaps with subcutaneous tissue pedicle to repair various wounds of extremities adds up to 40 cases(trauma 32 cases,tumor 5 case,burns 3 cases,)and flap area was ranged from 2 cm × 4 cm-4 cm × 12 cm.Evaluated the appearance and functions of the flaps.RESULTS 33 cases were survived completely,and only 7 were with part of the necrotic flap,which were cured at last after dressing and skin-grafting.Followed up 25 cases from 2 months-1 year,their appearance and functions,such as color and elasticity were satisfied.CONCLUSION Using fasciocutaneous flaps with adipotascial-flap pedicel to repair various wounds of extremities is a new choice for us,because of the less destroy in donor area,and with convenience and high rate of survival.