埋线法结扎周边血管预防扩张皮瓣静脉淤血的疗效观察_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

姚媛媛 ,  张金明 , 梁伟强 , 陈宇宏 , 冀晨阳 , 张佳琦

中山大学孙逸仙纪念医院整形外科（广州，510120）;

Corresponding author：

张金明, Email: zxmrwk@me.com

Keywords：

扩张皮瓣; 静脉淤血; 血管结扎; 静脉延迟

DOI：

10.7507/1002-1892.20150170

Video：

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目的总结埋线结扎扩张皮瓣周边血管主干预防皮瓣静脉淤血的疗效。方法 2012年2月－2014年5月，对6例扩张穿支皮瓣通过埋线结扎皮瓣周边蒂部以外静脉主干行静脉延迟。其中男5例，女1例；年龄12～62岁，平均29.7岁。大面积鲜红斑痣及烧伤后挛缩瘢痕各2例，采用扩张颈横动脉胸段皮支皮瓣修复；重度尿道下裂1例，采用扩张侧腹部皮瓣行阴茎再造；足踝及足背部瘢痕挛缩1例，采用扩张逆行胫后动脉穿支交腿皮瓣修复。供区均直接缝合。结果皮瓣扩张过程顺利，无并发症发生。6例皮瓣均行1次埋线结扎。皮瓣获取术中及术后颜色均无异常改变，未见淤血现象，并全部成活。供区切口Ⅰ期愈合。患者均获随访，随访时间5～24个月，平均10.2个月。皮瓣颜色、外形、质地均较满意。结论通过埋线结扎周边血管主干阻断静脉回流方法对扩张皮瓣进行静脉延迟，可有效预防术后静脉淤血，提高皮瓣成活率，而且操作简便，创伤小，效果良好。

Citation： 姚媛媛, 张金明, 梁伟强, 陈宇宏, 冀晨阳, 张佳琦. 埋线法结扎周边血管预防扩张皮瓣静脉淤血的疗效观察. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 789-791. doi: 10.7507/1002-1892.20150170 Copy

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2.	Wu CC, Lin PY, Chew KY, et al. Free tissue transfers in head and neck reconstruction:complications, outcome sand strategies for management of flap failure:analysis of 2019 flaps in single institute. Microsurgery, 2014, 34(5):339-344.
3.	Enajat M, Rozen WM, Whitaker IS, et al. A single center comparison of one versus two venous anastomoses in 564 consecutive DIEP flaps:investigating the effect on venous congestion and flap survival. Microsurgery, 2010, 30(3):185-191.
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6.	Gözü A, Poda M, Taşkin EI, et al. Pretreatment with octreotide modulates iNOS gene expression, mimics surgical delay, and improves flap survival. Ann Plast Surg, 2010, 65(2):245-249.

1. Talbot SG, Pribaz JJ. First aid for failing flaps. J Reconstr Microsurg, 2010, 26(8):513-515.
2. Wu CC, Lin PY, Chew KY, et al. Free tissue transfers in head and neck reconstruction:complications, outcome sand strategies for management of flap failure:analysis of 2019 flaps in single institute. Microsurgery, 2014, 34(5):339-344.
3. Enajat M, Rozen WM, Whitaker IS, et al. A single center comparison of one versus two venous anastomoses in 564 consecutive DIEP flaps:investigating the effect on venous congestion and flap survival. Microsurgery, 2010, 30(3):185-191.
4. Wong CH, Tan BK. Intermittent short saphenous vein phlebotomy:an effective technique of relieving venous congestion in the distally based sural artery flap. Ann Plast Surg, 2007, 58(3):303-307.
5. Ghali S, Butler PE, Tepper OM, et al. Vascular delay revisited. Plast Reconstr Surg, 2007, 119(6):1735-1744.
6. Gözü A, Poda M, Taşkin EI, et al. Pretreatment with octreotide modulates iNOS gene expression, mimics surgical delay, and improves flap survival. Ann Plast Surg, 2010, 65(2):245-249.

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埋线法结扎周边血管预防扩张皮瓣静脉淤血的疗效观察

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