The Clinical Comparison Of The Subdermal Vascular Network Flap In Different Pedicle Division Time

Objective:To compare the clinical therapeutic effects of the subdermal vascular network skin flap in different pedicle division time.Methods:From July2003to December2010,96patients using the ilioinguinal subdermal vascular network skin flap in the repair of wounds of the hand were included in the study. Their follow-up time was more than6months.81patients were male and15patients female,whose ages were17to56years.31patients’ pedicle division time was2to3weeks (group A),25patients’pedicle division time was longer than3weeks (group B),19patients’pedicle division time was longer than4weeks (C group),and21patients’pedicle division time was longer than5weeks (group D). Their flap making method, postoperative nursing measures and pedicle division operation and rehabilitation measures were the same.The flap survival rate、 wound infection rate、recovery of shoulder hand function recovery、the skin quality and the restore preinjury activity time were used to evaluate the curative effect.Results:All flaps of4groups survived. Four groups of the skin quality and recovery of hand function had not statistical significance (P>0.05). After1week、1month、6months follow-up,the shoulder joint function recovery situations in different group had a significant difference (P1w<0.001,P1m<0.001,P6m<0.05).In Agroup, the shoulder joint function recovered the best.The postoperative wound infection rates had a significant difference(P<0.001).The wound infection rate of A group was the lowest(41.9%). The time to return to preinjury activity has a significant difference (P<0.001).The recovery preinjury activity time of A group was the shortest(6.1±0.9W).Conclusion:When the pedicle division time was2-3weeks,the subdermal vascular network skin flaps survived well.The wound infection rate was the lowest,their shoulders function were the best and the time of return to preinjury activity was the shortest. They had the best clinical efficacy.As the pedicle division time prolonging,the patients’wound infection rate increased, their shoulder joints recovery time prolonged,and the time to recover their preinjury activity prolonged.