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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (09) : 700 -703. doi: 10.3877/cma.j.issn.1674-0785.2020.09.007

所属专题: 文献

临床研究

腹壁下动脉穿支皮瓣延迟带蒂转移修复前臂大面积软组织缺损
张功林1, 冯致举1, 师富贵1, 王建东2, 何如祥1, 胡军1,(), 孙萍1, 岳孝太1, 赵文学1, 王伟世1   
  1. 1. 730050 兰州手足外科医院手外科
    2. 734000 甘肃张掖,河西学院附属张掖人民医院骨科
  • 收稿日期:2020-03-19 出版日期:2020-09-15
  • 通信作者: 胡军
  • 基金资助:
    兰州市科技局项目(2018-4-60)

Delayed pedicled deep inferior epigastric perforator flap transfer to repair large forearm soft tissue defects

Gonglin Zhang1, Zhiju Feng1, Fugui Shi1, Jiandong Wang2, Ruxiang He1, Jun Hu1,(), Ping Sun1, Xiaotai Yue1, Wenxue Zhao1, Weishi Wang1   

  1. 1. Department of Hand Surgery, Lanzhou Hand and Foot Surgery Hospital, Lanzhou 730050, China
    2. Department of Orthopaedics, Zhangye People’s Hospital Affiliated to Hexi College, Zhangye 734000, China
  • Received:2020-03-19 Published:2020-09-15
  • Corresponding author: Jun Hu
  • About author:
    Corresponding author: Hu Jun, Email:
引用本文:

张功林, 冯致举, 师富贵, 王建东, 何如祥, 胡军, 孙萍, 岳孝太, 赵文学, 王伟世. 腹壁下动脉穿支皮瓣延迟带蒂转移修复前臂大面积软组织缺损[J]. 中华临床医师杂志(电子版), 2020, 14(09): 700-703.

Gonglin Zhang, Zhiju Feng, Fugui Shi, Jiandong Wang, Ruxiang He, Jun Hu, Ping Sun, Xiaotai Yue, Wenxue Zhao, Weishi Wang. Delayed pedicled deep inferior epigastric perforator flap transfer to repair large forearm soft tissue defects[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(09): 700-703.

目的

探讨腹壁下动脉穿支(DIEP)皮瓣延迟带蒂转移修复前臂大面积软组织缺损的临床应用价值。

方法

选择2012年1月至2018年1月在兰州手足外科医院就诊的前臂大面积软组织缺损患者9例,采用DIEP皮瓣延迟带蒂转移进行修复,分析其临床效果。患者年龄18~51岁,软组织缺损范围24.0 cm×8.0 cm~32.0 cm×8.5 cm。DIEP皮瓣以外侧穿支供血,供区直接缝合。皮瓣延迟的时间6~10 d;断蒂时间18~21 d。

结果

1例发生小的皮缘裂开,术后2周自然愈合,皮瓣全部成活。术后随访2.0~4.5年,平均(3.8±1.4)年。供区切口愈合好,未发生腹壁切口疝,未见明显功能障碍;受区外形、功能均恢复较好,临床效果均满意。

结论

DIEP皮瓣延迟带蒂转移修复前臂大面积软组织缺损安全、可靠,可降低对供区的损伤。

Objective

To explore the clinical application of delayed pedicled deep inferior epigastric perforator (DIEP) flap transfer for repairing large forearm soft tissue defects.

Methods

From January 2012 to January 2018, nine patients with large soft-tissue defects in the forearm underwent reconstruction by delayed pedicled DIEP flap transfer at Lanzhou Hand and Foot Surgery Hospital, and the clinial effect was analyzed. They ranged in age from 18 to 51 years (mean, 36 years). The size of soft-tissue defects in the forearm ranged from 24.0 cm×8.0 cm to 32.0 cm×8.5 cm. The lateral branch provided the blood supply to the DIEP flap. The donor site was closed directly. Time of flap delay was 6~10 d. Time of pedicle break was 18-21 d.

Results

One patient developed small wound dehiscence, which spontaneously healed two weeks after surgery. All the flaps had survived completely. Postoperative follow-up period ranged from 2.0 to 4.5 years (mean, 3.8 years). The incision healed well, no abdominal incision hernia occurred, and no obvious dysfunction was found. A good contour was confirmed at the recipient area. Satisfactory clinical results were obtained in the cases.

Conclusion

Delayed pedicled DIEP flap transfer is a good option to repair large soft tissue defects in the forearm. This technique is safe and reliable, with minimal donor site morbidity.

图1 术前右前臂与肩部创面情况
图2 腹壁下动脉穿支皮瓣延迟后外形
图3 修复前臂创面后
图4 前臂大面积软组织缺损患者术后5个月前臂外形
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