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-  2015 

桡动脉掌浅支腕横纹部flow-through皮瓣修复伴动脉缺损的拇指创面

DOI: doi:10.7507/1002-1892.20150099

Keywords: flow-through皮瓣, 桡动脉掌浅支, 动脉缺损, 拇指创面

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Abstract:

目的探讨采用桡动脉掌浅支(superficial palmar branch of the radial artery,SPBRA)腕横纹部flow-through皮瓣修复伴动脉缺损的拇指创面方法及疗效。 方法2012年2月-2013年11月,收治8例伴双侧动脉缺损的拇指软组织缺损患者。男5例,女3例;年龄19~51岁,平均30.5岁。致伤原因:挤压伤4例,撕脱伤3例,绞勒伤1例。致伤部位:掌指关节3例,近节掌侧2例,指间关节掌侧3例。软组织缺损范围3.5 cm×1.5 cm~6.5 cm×2.0 cm。指动脉缺损2.5~8.5 cm,平均5.3 cm。受伤距手术时间2.0~4.5 h,平均3.2 h。采用SPBRA腕横纹岛状皮瓣逆行移位修复,皮瓣切取范围4.0 cm×2.0 cm~7.5 cm×3.0 cm。供区直接缝合。 结果除1例因血管变异改变术式外,其余均顺利完成手术。术后皮瓣均完全成活,创面Ⅰ期愈合;供区切口均Ⅰ期愈合。患者均获随访,随访时间6~18个月,平均13个月。皮瓣颜色及质地与周围正常皮肤相似,供区无明显瘢痕,腕部功能正常。末次随访时,患指功能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6例,良1例,中1例,优良率87.5%。 结论SPBRA腕横纹部flow-through皮瓣修复伴动脉缺损的拇指软组织缺损,具有手术操作简便、血运可靠、术后手部功能及外观恢复好的优点

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