척골동맥 피판술을 이용한 수부 재건술

Distally based Ulnar Artery Flap for Reconstruction of Hands

  • 안병우 (성균관대학교 의과대학 마산삼성병원 정형외과학교실) ;
  • 윤종호 (성균관대학교 의과대학 마산삼성병원 정형외과학교실) ;
  • 정성원 (성균관대학교 의과대학 마산삼성병원 정형외과학교실) ;
  • 김기환 (성균관대학교 의과대학 마산삼성병원 정형외과학교실)
  • Ahn, Byung-Woo (Department of Orthopedic Surgery, Masan Samsung Hospital, College of Medicine, Sungkyunkwan University) ;
  • Yoon, Jong-Ho (Department of Orthopedic Surgery, Masan Samsung Hospital, College of Medicine, Sungkyunkwan University) ;
  • Jung, Sung-Weon (Department of Orthopedic Surgery, Masan Samsung Hospital, College of Medicine, Sungkyunkwan University) ;
  • Kim, Ki-Hwan (Department of Orthopedic Surgery, Masan Samsung Hospital, College of Medicine, Sungkyunkwan University)
  • 발행 : 2008.11.30

초록

Purpose: We reconstructed the skin defect of hands exposing tendons and/or bone with distally based ulnar artery flap and report our cases. Materials and Methods: Between March 2005 and September 2007, 6 cases of skin defect were reconstructed with distally based ulnar artery flap. Defect site were 5 cases of hand dorsal side and 1 case of hand volar side. The average defect size was $3{\times}3\;cm^2$. There were 4 men and 2 women and mean age was 55.5 years. We evaluated the viability of flap, postoperaive complication, healing time, patient's satisfaction. Results: There was no flap failure in 6 cases. But 1 case with recurrent discharge was healed with several times adequate debridement and delayed suture. 1 case with flap edema which might be due to venous congestion was healed with hand elevation and use of low molecular weight heparin. Mean time to heal the skin defect was 4 weeks. No infection and recurrence was found in follow up period. Cosmetic results as judged by patients were that 3 cases are good and 3 cases are fair. Conclusion: Distally based ulnar artery flap is good treatment method among the numerous methods in the cases of skin defect, with soft tissue exposed, which is not covered with debridment and skin graft. Distally based ulnar artery flap is useful method for the skin defect of hands because it is simple procedure, has constant blood supply and relatively good cosmetic effect.

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