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皮瓣(flap) |
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皮瓣(flap):皮瓣是指移植時仍保有血液循環者,比skin graft 厚。
• 局部皮瓣(local flap):可分為隨意皮瓣(random flap)及同軸皮瓣(axial flap)二大類
• 如’Z’, 'V-Y', ‘Y-V', 五片皮瓣(5-Flap)成形術等隨意皮瓣,多用於帶狀疤痕之鬆解,如指縫帶狀疤痕------手指屈面或側面帶狀疤痕引起的縮。
• 交指皮瓣(cross finger flap)及脂肪肌膜皮瓣(adipofascial flap)也可用於燒傷重建。
• 其他局部皮瓣如類菱形皮瓣(rhomboid flap, 即Limberg flap),旋轉皮瓣(rotation flap),或前進皮瓣----(advancement flap)。
• 額皮瓣(forehead flap)及鼠蹊皮瓣(groin flap)等,屬於同軸皮瓣(axial flap),可形成島狀皮瓣(island flap)。
• 遠端皮瓣(distant flap)
沒有局部皮瓣可用時,可考慮遠端皮瓣。常用的有腹部皮瓣(abdominal flap),鼠蹊皮瓣(groin flap),需將受皮區固定在供皮區2-3星期之後,再做皮瓣分離手術,這段期間,影響病患日常生活較大。
• 自由皮瓣 (free flap)
當傷口太大,縮太嚴重,或沒有局部皮瓣可以覆蓋傷口時,可以考慮以顯微手術接合自由皮瓣,其缺點為供皮區缺陷,及可能的皮瓣壞死。 |
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上圖:皮瓣(flap) |
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下圖:皮瓣(flap) |
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