手外伤软组织缺损经不同皮瓣修复疗效分析

目的分析探讨不同皮瓣修复术在手外伤软组织缺损患者中的应用和疗效。方法选取2010年5月至2013年5月期间襄阳市第一人民医院收治的手外伤软组织缺损患者104例。根据手术前患者手部软组织的缺损情况,分别进行腹部带蒂皮瓣修复23例、指尺侧及环指桡侧岛状皮瓣修复21例,锁骨下带蒂皮瓣修复19例,手掌背动脉逆行岛状皮瓣修复17例,V-Y皮瓣修复9例,双三角皮瓣修复6例,手指掌側推进皮瓣修复5例,第一掌背动脉岛状皮瓣修复3例,骨间背側动脉逆行岛状皮瓣修复1例。结果手术结束后104例皮瓣全部成活,经过术后2个月至1年的随访调查发现,有76例患者对损伤部位外形和功能恢复较为满意,20例皮瓣出现了轻度臃肿,8例患者对皮瓣供区植皮的外形不满意。结论根据患者手部软组织的缺损情况,对缺损部位采取不同的皮瓣修复术,避免可较大瘢痕的产生,促进损伤部位外形和功能的恢复,降低感染率,提高患者的生存质量和生活信心。

Analysis on the Effect of Different Skin Flap Repair Methods in the Treatment for Soft Tissue Defect Caused by Hand Injuries

Objective To investigate the effect of different skin flap repair methods in the treatment for soft tissue defect caused by hand injuries. Methods A total of 104 cases of patients with soft tissue defect of hand admitted in Xiangyang First People＇s Hospital from May 2012 to May 2013 were selected as objects. According to different states of defect before operation, different skin flap repair methods were used, including pedicled abdominal flap （ 23 cases ） , finger ulnar and radial side of the ring finger island flap （ 21 eases） , subclavicular pedicle flap（ 19 cases） ,palm dorsal artery retrograde island flap（ 17 cases） ,V-Y flap（9 cases）, double triangular flap（6 cases） ,finger volar advancement flap （5 cases） ,the first dorsal metacarpal artery island flap （ 3 cases）, dorsal interosseous artery retrograde island flap （ 1 case）. Results After operation, all flaps survived in 104 cases. Results of the follow-up and questionnaire survey 2 months to 1 year after operation showed 76 cases were satisfied with appearance and functional recovery of injury site, slight bloat occurred to 20 cases, and 8 cases were not satisfied with the appearance of injury site. Conclusion Choosing different skin flap repair to treat patients with hand soft tissue defect according to the patients＇ specific state of defect can avoid the occurrence of big scar, and enhance the recovery of the appearance and function of injury site, as well as lower the infection rate and improve the life quality and confidence of the patients.