腹部“S”型瓦合真皮下血管网皮瓣的设计及临床应用

目的:评价腹部“S”型瓦合真皮下血管网皮瓣的设计及临床应用的可行性。方法:采用笔者设计的腹部“S”型瓦合真皮下血管网皮瓣修复手部掌背侧撕脱伤、烧伤后皮肤瘢痕挛缩及手指脱套伤8例,其中应用大“S”型瓦合皮瓣5例。小“S”型瓦合皮瓣2例,连续多个小“S”型瓦合皮瓣1例。结果:8例皮瓣一期全部成活,其中1侧皮瓣远端青紫起泡,表面坏死经换药后痊愈。6例随访2～6年,皮瓣的外形、色泽、弹性、柔软度均良好。结论:(1)腹部“S”型瓦合真皮下血管网皮瓣为双蒂,转移至受区后,血供充足,生长良好,可缩短断蒂时间。(2)皮瓣设计简单,手术操作容易且安全,成功率高,易于推广。(3)因是超薄皮瓣,成活后不需再次手术作分指术和皮瓣修薄术,外观良好,且有利于早期功能锻炼。

Design and Application of Abdominal "S" Shape Watte Flaps with Dennis Vascular Net

Objective: To evaluate the design and clinical application of abdominal"S" shape watte flaps with dermis vascular net. Methods: 8 cases of avulsion on the back of the hand, skin cicatrices resulting from bum and finger' s glove -avulsion wound were repaired by abdominal "S" shape watte flaps with dermis vascular net the author designed. Big abdominal "S" shape watte flaps with dermis vascular net were used in 5 cases,small abdominal "S" shape watte flaps in 2 cases and several successive small abdominal "S" shape watte flaps in 1 cases. Results:Flaps in all the 8 cases survived by one stage including one with purpura blister and necrosis in the distal side, which recovered after dressing change. 6 cases were followed up for 2 to 6 years, the outline color elasticity and flexbility of the flaps were satisfactory. Conclusions: (1) abdominal "S" shape watte flaps with dermis vascular net has double pedicles. When transplanted to the target area,it has bettter blood - supply and grows well, thus shortens the cut - pedicle - time. (2) The design of the flaps is simple. The operation is easy to handle and a high rate of success can be achiened. (3)As the flap is ultrathin the operation of seperation and cutting thinner is unnecessary after its survival it keeps an good outline and patients can start exercise early.