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"尺动脉腕上皮支" 5 results
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目的
总结尺动脉腕上皮支双叶游离皮瓣修复手指复杂创面的方法和临床效果。
方法
2009年5 月－2012年5月，对12例手指复杂创面患者采用以尺动脉腕上皮支为蒂，分别以其上行支和下行支为轴心血管的双叶游离皮瓣修复。其中男7例，女5例；年龄20～45岁，平均31岁。手指脱套伤2例，相邻两指软组织缺损4例，一指两处缺损6例。缺损范围6.0 cm × 1.5 cm～10.0 cm × 3.0 cm。皮瓣切取范围为上叶5.0 cm × 2.0 cm～8.0 cm × 4.0 cm，下叶3.5 cm × 1.8 cm～6.0 cm × 3.0 cm。供区直接缝合或游离植皮修复。
结果
1例术后12 h出现动脉危象，1例上叶皮瓣远端表皮部分坏死，经相应处理后愈合；其余皮瓣及供区植皮均顺利成活，切口Ⅰ期愈合。11例获随访，随访时间6～18个月，平均11个月，皮瓣颜色及质地与周围正常皮肤相似，手指外形满意。手指恢复部分浅感觉，两点辨别觉为6～8 mm，平均7 mm。术后6个月，按中华医学会手外科学会上肢部分功能评定试用标准评定，获优7例，良3例，中1例，优良率90.9%。
结论
尺动脉腕上皮支的上、下行支管径与指血管匹配，以此为蒂的双叶游离皮瓣修复后外观、感觉恢复满意，是修复手指复杂创面的理想方法之一。
Release date：2016-08-31 04:05
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Objective To evaluate the cl inical efficacy of akin united flaps pedicled with dorsal carpal branch of ulnar artery in repairing compl icated degloving injuries of the opposite fingers. Methods Between August 2005 and August 2009, 11 cases of compl icated degloving injuries of single finger were treated, including 8 males and 3 females with an average age of 26 years (range, 19-55 years). The defect locations were thumb in 1 case, index finger in 7 cases, and middle finger in 3 cases, including 9 cases of mechanical injury and 2 cases of traffic accident injury. The extent of skin avulsion was the proximal segments or beyond the middle segment of finger with a defect range from 5.0 cm × 4.5 cm to 8.0 cm × 5.5 cm. Compl icated injuries included phalangeal fracture in 2 cases, extensor tendon injury in 3 cases, flexor and extensor tendon injuries in 1 case, digital vascular injury in 9 cases, and digital nerve injury in 6 cases. The time from injury to operation was 2-18 hours (mean, 4.8 hours). The akin united flaps were designed on the basis of anatomical distribution of the dorsal carpal branch of ulnar artery. The proximally pedicled flaps enclosed palmar finger, and the distally pedicled flaps enclosed dorsal finger. The size of flaps ranged from 10 cm × 3 cm to 16 cm × 3 cm. The donor sites were sutured directly. After 3 weeks, the pedicle was cut. Results Light yellow secretion and eczema on the flap were observed in 1 case at 3 days, were cured after 2 weeks of dressing change; other flaps survived and healing of incisions by first intention was achieved. The incisions at donor sites healed by first intention. The secondary plastic operation was performed in 2 cases because of bulky flaps at 3 months after operation. Eleven patients were followed up postoperatively 6-12 months (8 months on average). The texture and appearance of all the flaps were satisfactory. The two-point discrimination was 12-20 mm with satisfactory recovery of finger function at 6 months after operation. According to Jebsen standard, the results were excellent in 8 cases, good in 2 cases, and poor in 1 case. Conclusion With rel iable blood supply, easy dissection, less injury at donor site, and good repair results, the akin united flaps pedicled with dorsal carpal branch ofulnar artery is a good method to repair complicated degloving injuries of the opposite fingers.
Release date：2016-08-31 05:42
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目的 总结尺动脉腕上皮支游离皮瓣修复第2～5指掌侧皮肤软组织缺损的临床效果。 方 法 2003 年5 月－ 2009 年10 月，收治第2 ～ 5 指掌侧皮肤软组织缺损17 例19 指。男12 例，女5 例；年龄21 ～ 53 岁，平均38.6岁。机器伤12 例，交通事故伤3 例，切割伤2 例。损伤指别：示指5 例，中指6 例，环指4 例，小指4 例；其中2 例为相邻两指。14 例为急性损伤，伤后至入院时间为10 min ～ 7.5 h；3 例为伤后彻底清创后感染创面。创面范围5.0 cm × 1.5 cm ～ 7.5 cm × 4.5 cm。应用大小为6.5 cm × 2.5 cm ～ 9.0 cm × 6.0 cm 的尺动脉腕上皮支游离皮瓣修复缺损，供区直接缝合或游离植皮修复。 结果 术后1 ～ 6 d 4 例出现表皮张力性水疱，3 例皮瓣远端部分坏死，经对症处理后皮瓣成活；其余皮瓣均顺利成活，创面Ⅰ期愈合。供区切口均Ⅰ期愈合，植皮均成活。术后14 例获随访，随访时间6 个月～ 2 年6 月，平均1.3 年。皮瓣外形、质地、色泽均满意，两点辨别觉8 ～ 20 mm。手指功能参照关节主动活动度法（TAM）评定，获优8 例，良5 例，可1 例。 结论 尺动脉腕上皮支游离皮瓣是修复第2 ～ 5 指掌侧皮肤软组织缺损的有效方法之一。
Release date：2016-08-31 05:44
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目的 总结采用尺动脉腕上皮支皮瓣游离移植修复手指皮肤缺损，并利用其手背尺侧皮支重建手指末梢血运的临床疗效。 方法 2007 年5 月－ 2009 年5 月，收治6 例6 指中末节指腹皮肤缺损伴末梢血运障碍患者。男4 例，女2 例；年龄21 ～ 56 岁，平均31 岁。电锯伤4 例，其中中指2 例，示指1 例，环指1 例；合并屈肌腱断裂2 例。热压伤2 例，示、中指各1 例。采用尺动脉腕上皮支皮瓣游离移植修复缺损，手背尺侧皮支与远端指动脉吻合重建末梢血运。 结果 术后6 例皮瓣及患指均顺利成活，创面Ⅰ期愈合，无血管危象及感染发生。供区植皮成活，切口Ⅰ期愈合。4 例获随访，随访时间6 ～ 15 个月，平均8 个月。皮瓣无明显臃肿及瘢痕挛缩，患指功能恢复正常，远端指体感觉及皮瓣感觉恢复满意，两点辨别觉8 ～ 12 mm。 结论 采用带手背尺侧皮支的尺动脉腕上皮支皮瓣既可修复患指皮肤缺损，又可重建末梢血运，疗效满意。
Release date：2016-08-31 05:47
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目的 总结尺动脉腕上皮支下行支皮瓣游离移植修复手指软组织缺损的临床效果。 方 法 2008 年1 月－ 2009 年1 月，采用以尺动脉腕上皮支下行支作供血的尺动脉腕上皮支皮瓣游离移植修复手指软组织缺损10 例。男6 例，女4 例；年龄18 ～ 45 岁，平均38 岁。机器绞伤4 例，压砸伤3 例，切割伤3 例。缺损部位：手指近中节掌侧缺损2 例，手指中末节缺损3 例，手指侧方缺损3 例，指背近中节缺损1 例，指腹缺损1 例。缺损范围2.0 cm × 1.8 cm～ 6.0 cm × 4.0 cm。伤后至手术时间5 ～ 7 d。皮瓣切取范围2.0 cm × 1.8 cm～ 7.0 cm × 5.0 cm。供区直接拉拢缝合或植皮修复。 结果 1 例术后12 h 出现动脉危象，2 例术后24 h 皮瓣出现张力性水疱；其余皮瓣及供区植皮均顺利成活，切口Ⅰ期愈合。患者术后均获随访，随访时间1 ～ 2 年。皮瓣颜色及质地与周围正常皮肤相似，手指外形满意。术后1 年按中华医学会手外科学会上肢部分功能评定试用标准评定：优6 例，良3 例，可1 例，优良率90%。 结论 采用尺动脉腕上皮支下行支作供血的尺动脉腕上皮支皮瓣游离移植修复手指软组织缺损，切取方便，供区隐蔽且损伤小，外形和功能良好，是修复手指软组织缺损较理想的方法之一。
Release date：2016-09-01 09:04
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