摘要
目的 探讨采用足底撕脱皮肤预制皮瓣游离并修复足底软组织撕脱伤的临床效果.方法 回顾性分析2011年10月至2015年1月,本院诊疗的20例足底软组织撕脱伤患者,清创撕脱离体的皮肤软组织,将其削薄后打包移植于股外侧中段筋膜上预制足底皮瓣.3周后皮瓣成活,再行二期皮瓣移植术将皮瓣游离回植原位.术后常规抗感染,改善微循环,清洁换药等.结果 所有患者预制皮瓣血运丰富、全部成活,修复创面均一期愈合.但有2例患者发生血管危象和感染,探查发现部分皮缘坏死,经清洁换药后愈合.术后随访时间为6-24个月,平均为13个月,患者均恢复行走和负重能力.根据章鸣等制定的评定量表作为评定指标.其中优15例、良3例、可2例,优良率为90%.结论 采用足底撕脱皮肤预制游离皮瓣修复足底软组织撕脱伤能取得满意效果,值得临床推广应用.
Objective To investigate the clinical effect of repairing the avulsion injury of the plantar soft tissue with the prefabricated free skin flap. Methods From October 2011 to January 2015, 20 patients with plantar soft tissue tearing degloving injury were retrospectively analyzed. The tore skin soft tissue was given debridement, cut into thin pieces and packaged for transplantation into mid lateral fascia prefabricated heel flap. On the postoperative 3 weeks after surviving, the skin flap was re-transplanted to the original site. Postoperatively the patients were given routine anti-infection, microcirculation was improved, and dressing was performed. Results The blood supply of the prefabricated flaps were abundant and survived in all patients. The repaired wound obtained one-state healing. The vascular crisis and infection occurred in 2 cases. Surgical exploration revealed partial skin edge necrosis, which was restored to walking and weight-bearing capabilities. The patients were followed up for 6 to 24 months （average 13 months）. The curative effects were assessed accord-ing to the guidelines issued by Zhang Ming et al. Fifteen cases obtained excellent curative effects, 3 cases good, and 2 cases general with excellent rate being 90%. Conclusion The clinical effects of plantar avulsion skin flap in the repair of plantar soft tissue avulsion injury are satisfactory, which is worthy of clinical application.
出处
《骨科》
CAS
2016年第6期394-397,共4页
ORTHOPAEDICS
基金
温岭市科技项目(WLK2011-128)
台州市科技计划项目(1201ky47)
