摘要
背景:足踝部软组织缺损是创伤骨科临床治疗难点,皮瓣移植仍然是不可替代的治疗手段之一。目的:探讨利用两种不同游离穿支皮瓣修复足踝部软组织缺损的临床技术。方法:2006年8月至2012年4月,30例足踝部软组织缺损伴骨外露患者行皮瓣移植术。男24例,女6例,年龄3～52岁,平均28岁。术前应用负压封闭引流技术处理,创面范围6cm×8cm^11cm×23cm。其中游离胸脐穿支皮瓣修复12例,游离股前外侧穿支皮瓣修复18例。结果:术后30例皮瓣全部成活。随访时间为3～24个月,平均11.0个月。皮瓣修复后外形大部分满意,皮瓣末梢二点分辨觉为10～22mm,胸脐穿支皮瓣和股前外穿支皮瓣组术后3个月左右恢复S2以上感觉百分比分别达58.3%和68.8%。结论:足踝部软组织缺损的游离皮瓣选择采用股前外穿支皮瓣或胸脐动脉穿支皮瓣均可。穿支皮瓣能够减少二次手术比例。负压封闭引流技术能显著减少皮瓣感染比例。
Background： The treatment of soft tissue defect of ankle is a challenge for orthopaedic surgeon, and skin flap transplantation has been indispensable. Objective： The aim of this study is to evaluate the surgical technique and clinical significance of the therapy for ankle soft tissue defect with two different free perforator flaps. Methods： Free perforator flap transplantations were performed in 30 patients with soft tissue defect and exposed bone of the ankle between August 2006 and April 2012. There were 24 males and 6 females aged from 3-52 years. The wounds were covered by vacuum sealing drainage （VSD） before operation. The size of the wound varied from 6 cmx 8 cm to 11 cmx23 cm. Of them, 12 cases were repaired by thoraco-umbilical flap and 18 cases were repaired by anterolateral thigh flap. Results： All the 30 flaps survived. The mean duration of follow-up was 11.0 months （range, 3 to 24 months）. The appear- ance of the flaps was satisfactory, with 10 to 22 mm in 2-PD. The sensation percentage beyond S2was 58.3% and 68.8% for thoraco-umbilical flap and anterolateral thigh flap transplantations, respectively. Conclusions： Both free anterolateral thigh perforator flap and free thoraco-umbilical perforator flap are suitable for the soft tissue defect of ankle. Perforator flap can decrease secondary orthopaedic surgery. VSD can significantly decrease the infec- tion of the perforator flaps.
出处
《中国骨与关节外科》
2012年第4期348-351,共4页
Chinese Journal of Bone and Joint Surgery
基金
广州市科技攻关计划项目(2012Y2-00023)
关键词
穿支皮瓣
足踝
软组织缺损
负压封闭引流
perforator flap
ankle
soft tissue defect
vacuum sealing drainage
