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1、短蒂腹部交叉皮瓣修复手部创面临床应用［摘要］目的：探讨短蒂腹部皮瓣修复手部创面的广泛适用性及改进方法。方法：通过改进皮瓣设计及闭蒂方式、采用短蒂腹部皮瓣修复手部创面25例32处，手指19例(其中同侧双指3例、三指2例)、手背6例。皮肤缺损范围：最小1.5cmX2.Ocm、最大12cmX16cm。皮瓣范围：最小1.8cmX2.5cm、最大13cmX18cmo结果：所有皮瓣蒂部均一期闭合、术后一周蒂部干洁、皮瓣成活良好、质地外观佳，手功能恢复良好。结论：腹部皮瓣修复手部创面大多无需设计皮管，改进皮瓣设计及闭蒂方式的短蒂
2、腹部皮瓣即可达到封闭创面、减少渗出及感染机会，同时提高皮瓣利用率、减少副损伤、避免皮管臃肿、积血影响血供、促进血循环及感觉重建、可早期断蒂、利于功能恢复、外形更薄。［关键词］蒂部；腹部皮瓣；手部创面；设计改进；临床应用［中图分类号JR622［文献标识码］A［文章编号］1008-6455(2013)01-0118-02ClinicalApplicationoftheAbdominalFlapwithShortPedicelfortheWoundofHandTIANHeng,LIUHong-jun,GUJia-xian
3、g,ZHANGNai-chen,PANJun-bo,ZHANGWen-zhong(NorthernJiangsuPeople，sHospitalAffiliatedtoYangzhouUniversity,Handsurgery，Yangzhou225001,Jiangsu,China)Abstract:ObjectiveTodiscusstheextensivefeasibilityandimprovedmethodsoftheabdominalflapwithshortpedicelforthewoundofh
4、and.Methods25caseswith32woundsintheirhandswererepairedbytheimprovedabdominalflapwithshortpedicel,whichimprovedintheflapdesignandmethodsofpedicelclosure,ofwhom19caseswiththeskindefectofthefingers(3casesofwhomwithdoublefingersdefectinthesamehand,and2casesofwhomw
5、iththreefingers),other6cases?woundonthebackofthehand・Thesizeofskindefectwas1.5cmX2.0cmto12cmX16cm；thesizeoftheflapswas1.8cmX2.5cmto13cmX18cm.ResultsAllcases，pedicelwereclosedinoperationanddryinaweekafteroperation，allflapsachievedacompletesurvivalsthetextureand
6、appearanceweresatisfying,andhandfunctionweregood.ConclusionSkintubewasunnecessaryfortheabdominalflaptorepairthewoundofhandgenerally,theimprovedabdominalf1apwithshortpedicelwhichimprovedintheflapdesignandmethodsofpedicelclosurealsocouldclosewound、decreaseexudat
7、ionandinfectionprobability,andincreasetheutilizationrateofflap>reduceadditionaldamage、avoidswollensikntubeandhematoceletoaffecttheflap"sbloodsupply,promotebloodcirculationandsensationreconstruction,cutthepedicleandfunctionrecoverearly,andappearancewasmorethin.
8、Keywords：pedicel；abdominalflap；handwound；improveddesign；clinicalapplication腹部皮瓣因其操作简便、成活可靠、供区隐蔽、灵活实用等优点被作为手、前臂创面修复的常规选择［1］,然而传统腹部皮瓣因蒂部需闭合形成管状而导致有组织创伤大、废用多、局部积血肿胀影响血运、皮瓣实际可切取覆盖的面积受限
