摘要
目的探讨应用矩形推进皮瓣修复儿童足跟部皮肤缺损的方法及疗效。方法回顾性分析2014年5月至2015年6月收治的7例儿童跟腱周围皮肤缺损的患儿资料，男4例，女3例；平均4．3岁；皮肤缺损面积为3．4cm×2．7cm～5．5cm×4．0cm；有1例患者跟腱在止点处部分断裂，其余6例患者跟腱保持完整。清创后采用自行设计的矩形推进皮瓣修复足跟部皮肤缺损。跟腱部分断裂者先将有污染的残端切除，再闭合伤口。术后为降低皮瓣的张力，用1枚1．5mm克氏针将踝关节固定于跖屈位并用石膏托保护。结果术后皮瓣全部成活，有2例患儿伤口局部感染，经换药后愈合，其余伤口愈合良好。随访时间8～12个月（平均11．5个月），有2例患儿伤口瘢痕较明显，其余患儿皮瓣色泽、质地与周围组织接近，踝关节功能皆正常。结论矩形推进皮瓣操作简单、安全可靠，是修复儿童跟腱周围皮肤缺损的有效方法。
Objective To explore the clinical efficacy of rectangle advancement flaps used in the reconstruction of skin defects around the Achilles tendon in children. Methods From May 2014 to June 2015, 7 children with skin defects around the Achilles tendon were admitted to our trauma center. The areas of skin defect ranged from 3.4 cm× 2.7 cm to 5.5 cm × 4.0 cm. The integrity of Achilles tendon was preserved in 6 cases but the tendon insertion was partly disrupted in one case. The skin defects were reconstructed with self-designed rectangle advancement flaps after debridement. In the one case with the Achilles tendon partly disrupted, the contaminated tendon ends were excised before wound closure. The injured ankles were immo- bilized in plantar flexion with one 1.5 mm K-wire and plaster splint to decrease the postoperative tension of the flap. Results All the flaps survived completely by primary intention but local infection occurred in 2 wounds which was cured by second intention of dressing change. The follow-up periods ranged from 8 to 12 months （average, 11.5 months）. The scar around the flap was remarkable in 2 cases, but the flaps in the other cases appeared normal in terms of color and texture. The ankle function was satisfactorily normal in all the cases. Conclusion Our self-designed rectangle advancement flaps provide a simple, safe and reliable way to repair skin defects around the Achilles tendon in children.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2017年第6期537-539,共3页
Chinese Journal of Orthopaedic Trauma
关键词
足
创伤和损伤
外科皮瓣
儿童
Foot
Wounds and injuries
Surgical flaps
Child
