封闭负压引流结合掌背动脉穿支皮瓣、掌长肌腱移植修复手背复合组织缺损 |
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引用本文: | 张友,周宏斌,成杰. 封闭负压引流结合掌背动脉穿支皮瓣、掌长肌腱移植修复手背复合组织缺损[J]. 临床骨科杂志, 2016, 0(2): 193-196. DOI: 10.3969/j.issn.1008-0287.2016.02.022 |
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作者姓名: | 张友 周宏斌 成杰 |
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作者单位: | 宜昌市夷陵医院骨科,湖北 宜昌,443100 |
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摘 要: | 目的探讨封闭负压引流(VSD)技术结合逆行掌背动脉穿支岛状皮瓣、掌长肌腱移植修复手背复合组织缺损的临床疗效。方法应用VSD技术结合逆行掌背动脉穿支岛状皮瓣、掌长肌腱移植修复11例手背复合组织缺损患者。组织缺损面积1.8 cm×2.0 cm~3.0 cm×6.0 cm,切取皮瓣面积2.0 cm×2.5 cm~3.5 cm×7.0 cm。结果切取第2掌背动脉穿支岛状皮瓣7例,第3掌背动脉穿支岛状皮瓣2例,第4掌背动脉皮瓣皮支岛状皮瓣2例。皮瓣全部成活,无皮瓣感染病例。患者均获得随访,时间7~25个月。伤指关节功能、皮瓣外形较满意。末次随访时按手指总主动活动度(TAM)标准评估伤指功能:优6例,良3例,中2例。结论 VSD可有效控制创面炎症,结合逆行掌背动脉穿支岛状皮瓣、掌长肌腱移植修复手背复合组织缺损,外形及功能恢复满意、血运可靠,是一种较好的修复方法。
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关 键 词: | 封闭负压引流( VSD) 手损伤复合组织缺损 掌背动脉 穿支皮瓣 肌腱移植 |
Vacuum sealing drainage combined dorsal metacarpal artery perforator flap and palmaris longus tendon transplantation to repair complex tissue defect of dorsum of hand |
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Abstract: | Objective To investigate the therapeutic effect of vacuum sealing drainage ( VSD) combined with retro-grade dorsal metacarpal artery perforator flap and palmaris longus tendon transplantation to repair complex tissue de-fect of dorsum of hand. Methods 11 cases of complex tissue defect in the back of hand were treated by VSD com-bined with retrograde dorsal metacarpal artery perforator based island flap, palm long tendon transplantation. The tis-sue defect size was 1. 8 cm × 2. 0 cm~3. 0 cm × 6. 0 cm and the cutting flap size was 2. 0 cm × 2. 5 cm~3. 5 cm × 7. 0 cm. Results 7 flaps were based on the second dorsal metacarpal artery perforator, 2 flaps were based on the third dorsal metacarpal artery perforator, and 2 flaps were based on the fourth dorsal metacarpal artery perforator. All patients received follow-up for 7 ~25 months. All the flaps were survived with wonderful appearance and satisfied function of fingers. There was no infective case. According to the Total Active Motion ( TAM) criteria to evaluate the function of injury finger at the final follow-up,6 cases were graded as excellent,3 as good, 2 as fair. Conclusions VSD can valid control wound inflammation. The dorsal metacarpal artery perforator flap has good function,acceptable forma, and reliably blood supply. It is a good choice to use VSD combined with retrograde dorsal metacarpal artery perforator flap and palmaris longus tendon transplantation for resurfacing complex tissue defect of dorsum of hand. |
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Keywords: | vacuum sealing drainage( VSD) hand injuries complex tissue defect dorsal metacarpal artery perforator flap tendon graft |
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