超声去脂真皮下血管网皮瓣在手指皮肤撕脱伤中的应用

目的探讨超声去脂的真皮下血管网皮瓣在手指皮肤撕脱伤中的应用。方法1997年6月～2000年2月共收治23例47个手指，根据手指皮肤撕脱伤的伤情，在腹部按传统方法掀起带蒂皮瓣，用剪刀修剪皮下脂肪组织，再用超声方法去除贴近真皮下血管网的脂肪，使皮瓣达到理想的厚度，修复撕脱伤的手指。皮瓣最大范围为8cm×7cm，最小为4cm×3cm，皮瓣长宽比例为2～3∶1。术后5～7天断蒂。结果术后皮瓣全部成活，最大限度保留伤指长度，皮瓣厚薄适中，其中21例随访6～24个月，术后伤指指间关节活动度达功能位，痛、温和触觉恢复尚可，但皮肤精细感觉较差。结论超声去脂对真皮下血管网皮瓣无明显损伤，皮瓣厚薄适中，是修复手指皮肤撕脱伤简便、安全、实用的方法。

RECONSTRUCTION OF DIGITAL AVULSION WITH PRE-FABRICATED SUBDERMAL VASCULAR NETWORK SKIN FLAP BY ULTRASONIC LIPOSUCTION

OBJECTIVE: To investigate the clinical application of subdermal vascular network skin flap pre-fabricated by ultrasonic liposuction in reconstruction of digital avulsion. METHODS: Forty-seven injured fingers of 23 cases were treated from June 1997 to February 2000. Conventional abdominal skin flap was elevated, according to the size of digital avulsion, and subcutaneous fat was removed with scissors. Ultrasonic liposuction technology was adopted, in order to minimize the injury of subdermal vascular vessels, to remove the fat particles close to the vascular network. Finally, the pre-fabricated skin flap was used to repair the digital avulsion. The vascular pedicle was severed in 5 to 7 days after operation. The range of skin flap was 4 cm x 3 cm to 8 cm x 7 cm, and the ratio of length and width was (2 to 3) to 1. RESULTS: All the skin flaps were survived. Twenty-one patients were available for postoperative follow-up for 6 to 24 months. The motion of interphalangeal joint achieved functional recovery, and the sensation of pain, temperature and taction recovered well. CONCLUSION: Ultrasonic liposuction does not obviously injure the subdermal vascular network skin flap, it is a simple and safe method for treatment of digital avulsion.