| Objective：With the advancement of chain’s social progress economicsgrouth, the incidence of trauma more and more, and the incidence of handinjuries than other parts of the body higher refused to statistics about half ofthe open hand injury need for skin grafts. Upper abdominal pedicle flap ofskin defects, is one of the oldest surgical and clinical follow the most basicway. Even in modern microsurgical techniques evolve and mature today, moreand more variety of tissue flaps, and the use of such methods to repair the skinof upper limb is still a lot of cases. With the advent of sub dermal capillarynetwork, abdominal pedicle flap more and more applications. But payabdominal flap postoperative limb joints fixed a long time, the patient couldeasily lead to shoulder and elbow stiffness, joint pain, reduced mobility, theimpact of postoperative upper limb function and quality of life. Payabdominal flap shoulder and elbow surgery dysfunction is hand injuriesduring treatment common problem, especially in elderly patients. Toinvestigate the clinical effect of ultra short wave combined with physicalexercise on preventing the dysfunction of shoulder and elbow joints inpatients with abdominal skin flap.Methods： A total of40patients (age>30years) with hand injuries wererandomly divided into two groups: Experimental group (group A), patientsreceived the ultra short wave therapy and the passive activities of shoulder andelbow after surgery, and the patients received standard rehabilitationexercise after dissection of the pedicles of abdominal flaps. Controlgroup(group B), patients received conventional nursing care without ultrashort wave therapy after dissection of the pedicles of abdominal flaps.Shoulder and elbow activity measurements, HSS score for shoulders andMayo score for elbows of patients were implemented after the surgeries. Pedicle were the first postoperative1day,1month after the measurement ofthe activity of the patients shoulder and elbow, and shoulder and elbow Mayoscore HSS score and pain VAS scores on the two sets of data to makestatistically analysis. Difference between the two groups was compared bystatistical analysis.Results：Two groups of patients were primary incision healed flapsurvival in patients with good, no infection and necrosis.The motion range ofjoints in the experimental group was better than the control group. HSS scorefor shoulders and Mayo score for elbows of patients in the experimental groupwere higher than the control group. Scale degree VAS pain score, the testgroup score lower than the control group, the difference was statisticallysignificant (P <0.05), the degree of pain and the experimental group than thecontrol group. Pedicle after one day in January to measure shoulder activity,pedicle after1day,1month experimental group abduction61.25±7.05°,81.35±6.56°greater than control group36.55±4.59°,57.50±8.08°, shoulder flexion test group101.25±5.91°,153.05±12.84°greaterthan the control group48.85±3.80°,89.75±15.11°, the experimentalgroup37.50±3.62°dorsiflexion shoulder,54.00±3.78°greater thanthe control group,30.20±4.72°,43.85±3.78°,(P <0.05). Thedifference was statistically significant. Elbow range of motion after one daypedicle77.90±12.14°experimental group than the control group49.65±9.29°, pedicle surgery in January115.40±13.42°experimental groupthan the control group87.15±16.91°(P <0.05). The difference wasstatistically significant.Conclusion：Upper abdominal pedicle flap to repair skin defect is asimple and effective, high survival rate, flexibility, surgery. The ultra shortwave combined with physical exercise therapy could improve the motionrange and the function of joints in patients with abdominal skin flap, reducejoint pain and improve the quality of life of patients. |
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