关键词: 手损伤, 脱套伤, 股前外侧皮瓣, 修复重建

Abstract:

Objective   To explore the study of free bilateral anterolateral femoral flaps in treating the whole hand degloving injury.  Methods   The study includes experiments of living body measurement and autopsy experiments. In the Living body measurement, 50 healthy adults without hand diseases were randomly selected. Skin of the hand were divided into two parts：the dorsal and palmar parts. The vertical and horizontal length of the palmar and dorsal parts of the skin was measured and recorded. The skin area was calculated from the above data according to the living body measurement. The autopsy experiments included model establishment and simulation operation. The models of degloving injuries of hands in two left hands of fresh cadaver specimens were established. We divided the wound and the degloved skin into two parts: the dorsal part and the palm part. The dorsal wounds of models of degloving injuries of hands were covered with the anterolateral femoral flap of the ipsilateral thigh and palm sides were covered by anterolateral femoral flap of the contralateral thigh.    Results    Among the measurement data of 50 healthy adults, the vertical length of the palmar part was (13.84±0.88)cm (12.51~15.03 cm), the width was (14.48±1.11) cm(12.85~16.66 cm). The vertical length of the dorsal part was (12.15±1.09) cm (10.77~13.77 cm) , and the width was (14.92±1.11) cm(14.92~17.33 cm). All data mentioned above were smaller than the maximal size of the flap reported in the literature.   Conclusion   Free bilateral anterolateral femoral flaps can respectively provide a large enough soft tisssue to cover the wound surface of dorsal and volar sides of the hand. The surgical approach of combined free bilateral anterolateral femoral flaps in treatment of degloving juries of the hand is feasible.

Key words: Hand injuries, Degloving injury, Anterolateral femoral flap, Reconstruction