组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2023, Vol. 19 ›› Issue (2): 124-.

• • 上一篇    下一篇

游离股薄肌肌皮瓣修复上肢软组织缺损

  

  • 出版日期:2023-04-01 发布日期:2023-05-09

Free gracilis myocutaneous flap in repairing soft tissue defect of upper extremity

  • Online:2023-04-01 Published:2023-05-09

PDF (PC)

62

摘要：

　目的　探讨游离股薄肌肌皮瓣修复上肢软组织缺损的临床应用和疗效。方法　回顾分析 2020 年 6 月至
2021 年 12 月，应用股薄肌肌皮瓣游离移植修复的 8 例上肢软组织缺损患者的临床资料。其中，男 5 例，女 3 例。
软组织缺损原因 ：交通事故伤 3 例，术后感染 2 例，血管瘤 1 例，电烧伤瘢痕挛缩 1 例，犬咬伤 1 例。创面部位 ：
手部 2 例，手背桡侧至前臂桡侧 1 例，前臂 4 例，肩部 1 例。创面范围 8 cm×6 cm~19 cm×12 cm，皮瓣切取范围
10 cm×7 cm~22 cm×15 cm。横向股薄肌肌皮瓣 4 例，纵向 2 例，三叶型 2 例。所有病例供区直接缝合。术后观察
皮瓣成活情况、并发症情况 ；定期随访，末次随访内容包括皮瓣色泽、质地、外观、感觉及供区外观等。结果　所
有皮瓣均成活，供、受区创面均Ⅰ期愈合。1 例术后出现供侧下肢水肿。随访 6~24 个月，平均 18 个月。所有皮瓣
色泽、质地良好，外观轻度臃肿，感觉迟钝。供区遗留线性瘢痕，外观评价良好。未对下肢功能产生不良影响。结
论　股薄肌肌皮瓣具有可塑性强、主要血管解剖变异少、供区位置隐蔽等优势，是修复上肢软组织缺损的可行选择。

关键词:

Abstract:

Objective　To explore the application and clinical effect of free gracilis myocutaneous flap in repairing soft tis
sue defect of the upper extremity. Methods　From June 2020 to December 2021, a total of 8 patients (5 males and 3 females)
with soft tissue defects in the upper extremity were repaired by the free gracilis myocutaneous flaps. The causes of soft tissue
defects: traffic accident injury in 3 cases, postoperative infection in 2 cases, hemangioma in 1 case, electric burn scar contrac
ture in 1 case, dog bite in 1 case. Wound site: hand in 2 cases, from the radial side of the back of the hand to the radial side of
the forearm in 1 case, forearm in 4 cases, shoulder in 1 case. The wound ranged from 8 cm×6 cm to 19 cm×12 cm. The skin
flap incision ranged from 10 cm×7 cm to 22 cm×15 cm, including 4 transverse gracilis myocutaneous flaps and 2 longitudinal
gracilis myocutaneous flaps and 2 tricuspid gracilis myocutaneous flaps. The donor site was sutured directly. The survival of flaps
and complications were observed after operation. Regular follow-up was performed. The last follow-up included color, texture,
appearance, sensation of the flap and appearance of the donor site. Results　All flaps survived, and the wounds in donor and
recipient sites healed by first intention. Postoperative edema of the donor side occurred in 1 case. The follow-up period ranged
from 6 to 24 months (mean, 18 months). All flaps had good color and texture, with slightly bloated appearance and dull sensation.
Linear scar was left at the donor site, and the appearance was well evaluated. There was no adverse effect on lower limb function.
Conclusion　The gracilis musculocutaneous flap has the advantages of strong plasticity, less variation in the anatomy of the
main vessels, and concealed donor site. It is a feasible choice for repairing the soft tissue defects of the upper extremity.

Key words: