四肢皮肤复合组织缺损应用游离胸脐皮瓣和股前外侧皮瓣修复的效果观察

蔡正强

【摘要】 目的：探析四肢皮肤缺损应用游离胸脐皮瓣和股前外侧皮瓣修复的效果。方法：选取本院2010年3月-2015年3月收治48例四肢皮肤复合组织缺损患者作为研究对象，按照随机数字表法将其分为A组和B组，每组24例。A组应用游离胸脐皮瓣进行修复，B组应用游离股前外侧皮瓣进行修复。比较两组患者的皮瓣成活率、二期手术修整率及并发症发生情况。结果：两组皮瓣成活率比较差异无统计学意义（P>0.05）。A组二期手术修整率为8.3%，明显低于B组的33.3%，差异有统计学意义（P<0.05）。A组并发症发生率为8.3%，明显低于B组的33.3%，差异有统计学意义（P<0.05）。结论：胸脐皮瓣应用于四肢皮肤缺损中皮瓣成活率高，术后并发症发生率低，外观良好，临床应用价值高。

【关键词】 四肢皮肤复合组织缺损； 胸脐皮瓣； 股前外侧皮瓣； 修复

【Abstract】 Objective：To explore the effect of free thoracic umbilical flap and anterolateral thigh flap in the repair of skin defect of limbs.Method：48 patients with complex tissue defect of skin of the limbs who were admitted to our hospital from March 2010 to March 2015 were selected as the research objects.According to the random number table method，they were divided into the group A and the group B，24 cases in each group.The group A adopted the free thoracic umbilical flap for repair，while the group B adopted the free anterolateral thigh flap for repair.The survival rate of flaps，repair rate of the two-stage operation and the incidence rate of complications between the two groups were compared.Result：The comparison of the survival rate of flaps between the two groups was not statistically significant（P>0.05）.The repair rate of two-stage operation in the group A was 8.3%，which was significantly lower than 33.3% in the group B，the difference was statistically significant（P<0.05）.The incidence rate of complications in the group A was 8.3%，which was significantly lower than 33.3% in the group B，the difference was statistically significant（P<0.05）.Conclusion：The survival rate of skin flaps after application of thoracic umbilical flaps in skin defect of extremities is high，and with less postoperative complications and good appearance，which is worthy of high clinical application value.

【Key words】 Complex tissue defect of skin of the limbs； Thoracic umbilical flap； Anterolateral thigh flap； Repair

First-authors address：Dongguan Guangji Hospital of Guangdong Province，Dongguan 523690，China

doi：10.3969/j.issn.1674-4985.2016.05.022

随着现代社会交通及工业的快速发展，复杂暴力及高能量骨折发生率逐渐升高，所引发肢体创伤与皮肤缺损也随之增多。四肢为皮肤缺损常见部位，临床治疗以手术修复为主[1]，若伴随骨、关节外露及神经或血管损伤，则皮肤缺损的修复难度将会增加，而所用修复皮瓣的选择对手术效果有较大影响。外伤性四肢皮肤缺损患者骨关节、肌腱、血管及神经外露几率高，游离植皮的修复效果并不理想[2]，因此临床多采用皮瓣移植对创面进行修复。随着显微外科血管吻合技术不断进步，四肢创面游离皮瓣移植修复方法逐渐增多，其中以胸脐皮瓣、股前外侧皮瓣较为常用[3]。本文以本院收治四肢皮肤复合组织缺损患者为例，探析四肢皮肤缺损应用游离胸脐皮瓣和股前外侧皮瓣修复的效果，现报告如下。

1 资料与方法

1.1 一般资料 选取本院2010年3月-2015年3月