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目的 探讨腹部带蒂皮瓣宽蒂部设计以及改良缝合方法修复上肢大面积皮肤缺损的可行性及疗效.方法 2014年3月-2016年8月,采用腹部带蒂皮瓣修复11例手部及前臂皮肤软组织缺损.男8例,女3例;年龄18～ 65岁,平均38岁.致伤原因:机器绞伤7例,交通事故伤4例.左上肢6例,右上肢5例.皮肤软组织缺损范围12 cm×7 cm ～ 20 cm×10 cm.受伤至手术时间2～5d,平均4d.采用下腹部皮瓣修复4例,脐旁皮瓣修复7例.皮瓣切取范围10 cm×9 cm ～ 22 cm×10 cm;皮瓣采用宽蒂部设计,蒂部宽8～ 18cm,平均15 cm;蒂部行改良缝合.术后3周断蒂.结果 术后皮瓣均成活,无淤血、坏死及张力性水疱发生;创面均Ⅰ期愈合.供区切口均Ⅰ期愈合.随访时间4～12个月,平均8个月.皮瓣色泽、质地、外形良好,皮瓣及供区均无溃疡形成.供区仅遗留线状瘢痕.结论 腹部带蒂皮瓣进行宽蒂部设计并改良缝合,可减少腹部皮肤组织浪费,避免术后感染,且手术操作简便,固定牢靠,修复上肢大面积皮肤缺损可行.“,”Objective To investigate the feasibility and effectiveness of designing wide pedicle of abdominal pedicled flap and repairing large skin defect of upper limb with improved suture method.Methods Between March 2014 and August 2016,11 cases with hand and forearm skin soft tissue defect were repaired with abdominal pedicled flaps.Among them,8 cases were male and 3 were female;aged 18-65 years (mean,38 years).The causes of injury were machinery injury in 7 cases and traffic accident in 4 cases.The wound located at left upper limb in 6 cases and right upper limb in 5 cases.The size of wound ranged from 12 cm×7 cm to 20 cm×10 cm.The interval from injury to operation was 2-5 days (mean,4 days).Four cases were repaired with lower abdominal flap and 7 with umbilical flap.The size of flap ranged from 10 cm×9 cm to 22 cm×l0 cm.And the flap was designed with wide pedicle at width of 8 to 18 cm (mean,15 cm);then the wound was sutured with improved method.The pedicle was cut after 3 weeks.Results All the flaps survived without congestion,necrosis,and tension blisters.The wound and the incision were both healed at stage Ⅰ.All patients were followed up 4-12 months (mean,8 months).The skin color,texture,and shape were satisfying,and no ulcer formed.Only line-like scar left at the donor site.Conclusion Abdominal pedicled flap with wide pedicle and improved suture method can reduce the abdominal skin waste,avoid postoperative infection,and be feasible to repair large skin defect of upper limb with advantages of simple operation and reliable fixation.