Thinned Groin Flap in Hand Reconstruction

腹股溝皮瓣是最常用來做為手部重建的方法之一，它不僅可提供豐富的皮瓣覆蓋，且供皮區的疤痕容易隱藏。但由於皮瓣過於肥厚，使得它在手部重建時，設計上及植入時受到相當的限制。重建的結果不易達到美觀的要求。為了克服這項缺點，我們將外側於前上腸骨突棘的遠端皮瓣，打薄至5公厘厚度，僅保留真皮下微血管網來做重建，從2000年9月至12月間共9位病患利用此薄皮瓣來覆蓋手部的軟組織缺損。同時利用雷射都卜勒來偵測皮瓣血流情形，希望能提供較準確的方法來判斷蒂時間。

關鍵字

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並列摘要

The pedicled groin flap is one of the most useful flaps in hand reconstruction. It provides a large amount of skin coverage with an easily concealed donor site. However flap bulkiness limits the design and insetting into complex 3-dimensional shapes. Aesthetics is thus less satisfactory and defatting procedures are often needed. To overcome these major drawbacks, a thinned pedicled groin flap was developed. We recorded our technique and experience with nine flaps performed from September 2000 to December 2000. These groin flaps were elevated and then thinned to the level of subdermal plexus. This resulted in a 5 mm thick flap distal to the anterior superior iliac spine. Each flap effectively covered the hand defects with no secondary defatting procedures required. Evaluation of flap perfusion was done using a Laser Doppler to record perfusion unit values from the proximal and distal region of the flap. All cases with complete viability had PU values of＞8 at the time of division. There were two complications which consisted of one total flap loss prior to division, one partial flap loss after division. The single case of partial necrosis had a proximal PU value of 5 at division time. Our technique of thinning to the subdermal plexus, lateral to the anterior superior iliac spine, and maintenance of proximal perfusion unit values ＞8 at division, make the thinned groin flap an effective technique for soft tissue hand reconstruction.

並列關鍵字

pedicled groin flap ； thinned flap ； hand reconstruction

國際替代計量

Thinned Groin Flap in Hand Reconstruction

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