远端蒂皮神经营养血管皮瓣内浅静脉干定时放血的临床研究

目的探讨能预防远端蒂皮神经营养血管皮瓣静脉危象和提高皮瓣成活质量的方法。方法58例大面积皮神经营养血管远端蒂皮瓣,早期25例术中皮瓣内浅静脉干远心端蒂部结扎,后期33例皮瓣内浅静脉干远心端蒂部结扎同时近心端留置静脉留置针外引流,每4小时放血1次,连续5天,比较两种处理后皮瓣静脉危象发生率及肿胀情况。结果结扎组均有明显肿胀期,5例出现静脉危象(占总体20.00%),3例皮瓣部分坏死;结扎 外引流组皮瓣全部成活,1例出现静脉危象(占总体3.33%),无明显肿胀期。随访1-2年,皮瓣质地柔软,无明显色素沉着。结论此方法能预防远端蒂皮神经营养血管皮瓣的静脉危象,提高皮瓣的成活质量。

Clinical study of regular flood drainage in superficial vein trunk on distal pedicled neurocutaneous flaps

Objective To investigate a way that can prevent venous drainage insufficiency and improve survival quality.Methods58 large area distal pedicled neurocutaneous flaps were carried out from 2003 to 2007,ligation at distal end of superficial vein trunk were performed in 25 flaps of them,ligation at distal end and drainage at proximal end of superficial vein trunk were performed in the other 33 flaps,then drain blood per 4 hours in 5 days.Blood supply and swelling of the flaps were observed postoperatively.ResultsAll 25 flaps were servious swollen,5 cases had venous drainage insufficiency(20.00%) and 3 cases had partial necrosis in the ligation group;In the ligation and drainage group all 33 flaps survived,1 case had venous drainage insufficiency and swelling(3.33%).All cases were followed up for 1-2 years;the flaps were soft and no pigmentation.ConclusionThe way can prevent venous drainage insufficiency and improve survival quality.