| 引用本文： |
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王扬剑,李学渊,王胜伟,等.术前多普勒定位的自由式穿支螺旋桨皮瓣设计[J].同济大学学报（医学版）,2016,37(4):109-114. [点击复制]
- WANG Yang-jian,LI Xue-yuan,WANG Sheng-wei,et al.Design of freestyle perforator pedicled propeller flaps using preoperative color Doppler ultrasonography localization[J].同济大学学报（医学版）,2016,37(4):109-114. [点击复制]
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| 摘要: |
| 目的 研究术前彩色多普勒超声定位的自由式穿支蒂螺旋桨皮瓣修复四肢皮肤软组织缺损的临床疗效及意义。方法 2012年2月至2014年7月,42例四肢肢皮肤软组织缺损患者采用术前彩色多普勒超声定位的自由式穿支螺旋桨皮瓣进行修复,穿支动脉分别来源于胫后动脉12例,拇指桡侧指动脉11例,尺动脉及腓动脉各5例,桡动脉及腓肠内侧动脉各3例,第一足背动脉2例,旋股外侧动脉1例。皮瓣面积2cm×5cm～7cm×25cm。结果 本组42例患者经术前彩色多普勒超声诊断仪检测,共检测出创缘附近穿支血管67条。临床手术中发现的穿支血管内径及其分布范围与术前彩色多普勒超声检查结果大致相符。术后40例皮瓣完全成活,术后无血管危象,无皮瓣淤紫及水泡；2例皮瓣远端部分坏死,经换药等对症治疗后愈合。24例供区切口直接缝合,18例供区植皮完全存活,切口均一期愈合。术后随访3～24个月,术后随访皮瓣颜色红润,质地优良,外观臃肿不明显,弹性良好。结论 术前彩色多普勒超声定位的自由式穿支蒂螺旋桨皮瓣操作简单、设计科学、血流符合生理、血供丰富且不牺牲主要动脉,临床实用性较强,有推广价值。 |
| 关键词: 穿支皮瓣 多普勒 螺旋桨 四肢 显微外科手术 |
| DOI：10.16118/j.1008-0392.2016.04.022 |
| 投稿时间：2015-12-15 |
| 基金项目: |
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| Design of freestyle perforator pedicled propeller flaps using preoperative color Doppler ultrasonography localization |
| WANG Yang-jian,LI Xue-yuan,WANG Sheng-wei,LIU Lin-hai,ZHOU Xiao-ling,YIN Feng |
| (Dept.of Orthopaedic, East Hospital, Tongji University, Shanghai 200120, China ;Dept.of Hand Surgery, Sixth People's Hospital of Ningbo, Ningbo 315240, Zhejiang Province, China) |
| Abstract: |
| Objective To design freestyle perforator pedicled propeller flaps by preoperative color Doppler ultrasonography(CDUS) localization for limb skin repair and soft-tissue defects. Methods Forty-two cases with limb soft tissue defect were repaired by freestyle perforator pedicled propeller flaps using CDUS localization preoperatively from February 2012 to July 2014. The origins of the perforator were from posterior tibial artery in 12 cases, from radial pollicis artery in 11 cases, from peroneal artery and ulnar artery in 5 cases respectively, from medial sural artery and radial artery in 3 cases respectively, from dorsal foot artery in 2 cases, from lateral circumflex femoral artery in 1 case. The size of flaps ranged from 2cm×5cm to 7cm×25cm. Results In 42 flaps involved,totally 67 perforator arteries were found by preoperative CDUS. The diameter and distribution of perforator arteries measured by CDUS were not different to findings in operation(P＞0.05). All 40 flaps survived without vascular crisis, purple bruise and bleb. Distal partial necrosis occurred in 2 cases which were healed finally. The donor site were closed directly in 24 cases and covered with free skin graft from abdomen in 18 cases. Patients were followed-up for 3~24 months, the appearance and function of these flaps were satisfactory. Conclusion Preoperative CDUS localization of freestyle perforator pedicled propeller can be used for repair of limb skin and soft defects, which is a simple, safe and versatile procedure. |
| Key words: perforator flap Doppler propeller limb microsurgical operation |
