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題名 | Temporoparietal Fascia Flap for Composite Defects of Dorsal Hands and Feet=游離顳額筋膜瓣於手足背側複合性缺損之應用 |
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作者姓名(中文) | 孫宗伯; 簡守信; 李俊達; 黃介琦; 鄭立福; | 書刊名 | 中華民國整形外科醫學會雜誌 |
卷期 | 9:4 2000.12[民89.12] |
頁次 | 頁217-224 |
分類號 | 416.413 |
關鍵詞 | 游離顳額筋膜瓣; 手足背側; 複合性缺損; Temporoparietal fascial flap; Microvascular reconstruction; Dorsal hands and feet; |
語文 | 英文(English) |
中文摘要 | 目的:手足背側的複合性傷口往往包括外露的肌腱、骨骼、以及關節。重建此等缺損所需要的皮瓣必須?薄且服貼、有豐富的血液供應、及提供伸肌肌腱保持滑動之介面。於此,我等提出一系列應用游離顳額筋膜瓣於手足背側複合性缺損之報告。病人及方法:於1996年5月至1999年7月間,共有15例以游離顳額筋膜瓣重建手足背側複合性缺損之病患,其中13例為男性,2例女性,年齡介於19歲至66歲中間,平均41.4歲。導致缺損之病因包括壓砸傷、燒燙傷、慢性潰瘍、以及糖尿病。所使用以資重建之皮瓣大小為6乘7公分至10乘12公分不等。結果:除一例用於重建手電擊傷之皮瓣因靜脈鬱積而失敗外,其他病例皆成功的重建並使之癒合。傷口的癒合更進而區分為良好、尚滿意、及不良等三等級,經統計吾人獲得73.3%良好,20%尚滿意,及6.7%不良之結果。結論:游離顳筋膜瓣具以下之優點:血管莖長及穩定、提供滑動介面、薄且血循豐富、供皮處破壞少、手術技巧難度不高、可同時由兩組人進行供皮區及受皮區之手術。由此一系列之結果得知游離顳額筋膜瓣十分適合用於手足背側複合性缺損之重建。 |
英文摘要 | PURPOSE: Composite defects of dorsal hands and feet involve exposed tendon, bone, and joints. Reconstruction of such defects requires thin, pliable, well-vascularized tissue with a gliding surface for the extensor tendon course. A series of 15 patients with composite defects of dorsal hands or feet, in whom free temporoparietal fascia flaps were used, are presented. PATIENTS AND METHODS: Between May 1996 and July 1999, fifteen free temporoparietal fascia flaps were used to reconstruct composite defects of dorsal hands and feet. There were 13 males and 2 females. Ages of patients ranged from 19 to 66 years with a mean of 41.4 years. The causes of defects include crushing injury; burn; chronic ulcer; and diabetes mellitus. Sizes of flap ranged from 6×7 to l0×12 cm. RESULTS: One flap was lost due to venous thrombosis in a hand defect arises from electric burn. Healing was defined as good when the defects healed primarily with good function after rehabilitation; satisfactory when repeat skin graft is needed for healing or mild limitation of range of motion; poor when the tissue transfer failed. We were able to achieve 73.3% good; 20% satisfactory; and 6.7% poor results. CONCLUSION: The free temporoparietal fascia flap has many advantages of long and constant vascular pedicle, provide a gliding surface, very thin and vascularized tissue, low donor site morbidity, ease of dissection, and the possibility of two team operation for simultaneous donor and recipient dissection. Our series demonstrate that the free temporoparietal fascia flap is particular suitable for reconstruction of composite defects of dorsal hands and feet. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。