带蒂逆行骨间后动脉穿支岛状皮瓣修复手部皮肤软组织缺损OA
Repair of Skin and Soft Tissue Defects in the Hand Using A Pedicle Retrograde Posterior Interosseous Artery Perforator Island Flap
目的:探究带蒂逆行骨间后动脉穿支岛状皮瓣修复手部皮肤软组织缺损的临床效果.方法:选取2019年3月-2024年3月南昌大学第一附属医院烧伤整形与创面修复医学中心治疗的23例手部皮肤软组织缺损患者为研究对象,均采用带蒂逆行骨间后动脉穿支岛状皮瓣修复.软组织缺损面积2.5 cm×3.5 cm～4.5 cm×7.0 cm,皮瓣切取面积3.0 cm×4.0 cm～5.0 cm×8.0 cm.供区直接拉拢缝合,无法直接拉拢缝合者采用头部或同侧上臂中厚皮片植皮.术后观察皮瓣成活情况及供区创面愈合情况,并定期通过电话、微信、门诊或互联网医院进行随访.结果:术后,3例皮瓣远端出现少许坏死,经再次手术后创面愈合,其余20例均成活;供区创面均一期愈合.23例均获随访,随访时间3～18个月,平均7.5个月.供受区均愈合良好,皮瓣外形及质地较好,皮瓣两点辨别觉10～25 mm,平均17 mm,腕部功能正常.结论:带蒂逆行骨间后动脉穿支岛状皮瓣修复手部皮肤软组织缺损术后皮瓣成活率高,外形及质地良好,功能良好,是修复手部皮肤软组织缺损的较好方法.
Objective To explore the clinical effect of using a pedicle retrograde interosseous artery perforator island flap to repair skin and soft tissue defects in the hand.Methods From March 2019 to March 2024,the Burn Plastic Surgery and Wound Repair Medical Center of the First Affiliated Hospital of Nanchang University treated 23 patients with hand skin and soft tissue defects repaired using a pedicle retrograde posterior interosseous artery perforator island flap.The area of soft tissue defect is 2.5 cm×3.5 cm-4.5 cm×11.0 cm,and the area of skin flap incision is 3.0 cm×4.0 cm-5.0 cm×12.0 cm.The supply area can be directly sutured,and for those who cannot be sutured directly,thick skin grafts from the head or ipsilateral upper arm can be used for skin grafting.After the operation,observe the survival of the flap and the wound healing in the donor area,and follow up regularly through telephone,WeChat,outpatient service or Internet hospital.Results After operation,3 cases showed slight necrosis at the distal end after surgery,after reoperation,the wound healed,while the remaining 20 cases all survived.All wounds in the supply area healed in stage I.All 23 cases were followed up for 3 to 18 months,with an average of 7.5 months.The donor and recipient areas have healed well,and the shape and texture of the skin flap are good.The two-point discrimination of the skin flap is 10-25 mm,with an average of 17 mm.The wrist function is normal.Conclusion The reverse interosseous artery perforator island flap with pedicle has a high survival rate,good appearance and texture,and good function for repairing skin and soft tissue defects in the hand.It is a good method for repairing skin and soft tissue defects in the hand.
邓如非;纪如晨;陈嘉欣;黄国能;胡翔天;姜臻宇;邹立津;张友来
南昌大学第一附属医院烧伤整形与创面修复医学中心 创烧伤及疼痛江西省重点实验室 江西 南昌 330000南昌大学第一附属医院烧伤整形与创面修复医学中心 创烧伤及疼痛江西省重点实验室 江西 南昌 330000南昌大学第一附属医院烧伤整形与创面修复医学中心 创烧伤及疼痛江西省重点实验室 江西 南昌 330000南昌大学第一附属医院烧伤整形与创面修复医学中心 创烧伤及疼痛江西省重点实验室 江西 南昌 330000南昌大学第一附属医院烧伤整形与创面修复医学中心 创烧伤及疼痛江西省重点实验室 江西 南昌 330000南昌大学第一附属医院烧伤整形与创面修复医学中心 创烧伤及疼痛江西省重点实验室 江西 南昌 330000南昌大学第一附属医院烧伤整形与创面修复医学中心 创烧伤及疼痛江西省重点实验室 江西 南昌 330000南昌大学第一附属医院烧伤整形与创面修复医学中心 创烧伤及疼痛江西省重点实验室 江西 南昌 330000
医药卫生
手部软组织缺损骨间后动脉穿支皮瓣带蒂逆行岛状皮瓣创面修复
handsoft tissue defectposterior interosseous artery perforator flappedicled reverse island flapwound repair
《中国美容医学》 2026 (4)
55-58,4
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