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我科应用带蒂轴型皮瓣肌皮瓣在临床上修复各种创面缺损24例,现就治疗体会报告如下。临床资料本组男23例,女1例;年龄9～53岁,平均27.4岁。受伤原因:爆炸伤2例,车祸伤4例,坑下砸伤18例。皮肤软组织缺损类型:膝前部缺损2例,足跟部缺损5例,拇指末节残端缺损2例,小腿内侧缺损4例,胫骨中下1/3骨折骨外露3例,手背部大面积缺损、肌腱外露2例,虎口部缺损1例,掌指关节残端缺损1例,拇指掌指关节残端缺损1例,骶部褥疮2例,左下肢膝下截肢残端缺损1例。以上病例均用带蒂轴型皮瓣肌皮瓣修复。断蒂时间:最短13天,最长18天,平均16.5天,术后均常规使用山莨菪碱30mg 静脉滴注1周。治疗结果:皮瓣转移覆盖创面全部成活。其中,1例骨间背侧逆行岛状皮瓣术后因静脉回流受阻出现严重水肿青紫,后经脱水,冷敷,切开引流治疗而成活。4例出现张力水泡,经脱水,冷敷,蒂部放置于松弛无张力位治愈。5例出现皮缘局部干性坏死,后经换药愈合。其余14例未出现异常情况,均Ⅰ期愈合。随访结
My department pedicle axial flap flap in the clinical repair of various wound defects in 24 cases, now on the treatment experience report is as follows. Clinical data The group of 23 males and 1 female; aged 9 to 53 years, mean 27.4 years old. Cause of injury: explosive injury in 2 cases, 4 cases of traffic accident, pit injured in 18 cases. Skin and soft tissue defect types: 2 cases of anterior knee defect, 5 cases of heel defect, 2 cases of distal stump defect in thumb, 4 cases of medial leg defect, 3 cases of middle and distal tibial fractures in 3 cases, large back defect , 2 cases of tendon exposure, 1 case of laryngeal defect, 1 case of metacarpophalangeal defect, 1 case of thumb metacarpophalangeal defect, 2 cases of sacral bedsore and 1 case of left lower extremity amputation stump defect. The above cases were pedicle shaft flap myocutaneous flap repair. Broken pedicle time: the shortest 13 days, the longest 18 days, an average of 16.5 days after surgery are routine use of anisodamine 30mg intravenous infusion for 1 week. Treatment outcome: All the wounds were covered by flap metastases. Among them, one case of interosseous dorsal retrograde island flap was severely edematous with purple due to obstruction of venous return, and then survived after dehydration, cold compress and incision and drainage. 4 cases of tension blisters, dehydration, cold, pedicle placed in a relaxed tension-free cure. 5 cases of dermal edge of the local dry necrosis, dressing after healing. The remaining 14 cases did not appear abnormalities, are Ⅰ healed. Follow-up conclusion