摘要
目的通过临床调查研究游离股前外侧穿支皮瓣在足跟部创面的应用情况,随访皮瓣预后及足部恢复情况得出相应的结论,为足跟部创面临床修复提供一些新的治疗思路。方法收集2019年8月-2021年3月于济南市中心医院创伤骨科与烧伤整复外科采用游离股前外侧穿支皮瓣修复足跟部创面56例患者的临床资料,通过门诊、电话、微信方式进行随访足部皮瓣恢复情况,并采用美国骨科足踝评分(AOFAS)、足功能指数(FFI)进行评定,最后得出相应的结论。结果56块股前外侧穿支皮瓣全部成活;其中3例发生动脉危象,2例发生静脉危象,经过探查重新吻合血管后皮瓣恢复血运;1例皮瓣远端部分坏死,予以清除坏死组织移植全厚皮片后愈合。足跟部外形恢复均可,较臃肿皮瓣,经1~3次皮瓣修薄整形手术,恢复较好外观,3~6个月恢复保护性痛觉与触觉,无皮肤溃疡,无张力性水疱形成,恢复负重及行走功能,均可满足基本日常活动需要。按美国骨科足踝评分(AOFAS)标准评定:优43例,良9例,可4例,优良占比93%;56例患足功能指数(FFI)均不超过70。结论股前外侧穿支皮瓣穿支血管较恒定,供区丰富,供区相对隐蔽,术后供区瘢痕不明显,皮瓣外观恢复良好,按美国骨科足踝评分(AOFAS)标准评定及足功能指数(FFI)提示患者术后足部功能恢复较好,可以认为游离股前外侧穿支皮瓣为足跟部创面修复的较好手术方案。
Objective To investigate and research the application of free anterolateral thigh perforator flap in heel wounds,and follow-up the flap prognosis and foot recovery,and draw corresponding conclusions,to provide some new treatment ideas for clinical repair of heel wounds.Methods The data of 56 patients with free anterolateral femoral perforator flap to repair the heel wound in the Department of Traumatology and Burn Rehabilitation of Jinan Central Hospital from August 2019 to March 2021 were collected,and follow-up was conducted through outpatient clinics,telephone calls and WeChat.The recovery of the foot flap was evaluated by the American Orthopaedic Foot and Ankle Score(AOFAS)and the Foot Function Index(FFI).Finally,the corresponding conclusions were drawn.Results All 56 anterolateral femoral perforator flaps survived,of which 3 cases had arterial crisis and 2 cases had venous crisis.After exploration and re-anastomosis,the flaps restoted blood supply,and the distal part of the flap was necrotic in 1 case,after removing necrotic tissue and transplanting a full-thickness skin graft,it healed.The shape of the heel could be recovered.For the bloated skin flap,after 1 to 3 times of skin flap thinning and plastic surgery,the appearance could be restored,and the protective pain and touch could be restored in 3 to 6 months.No skin ulcers,or formation of tension blisters occured and the recovery of weight-bearing and walking functions can meet the needs of basic daily activities.According to the American Orthopaedic Foot and Ankle Score(AOFAS)standard,43 cases were excellent,9 cases were good,and 4 cases were fair,accounting for 93%of excellent and good;56 cases of foot function index(FFI)did not exceed 70.Conclusion The anterolateral femoral perforator flap has relatively constant perforator vessels,abundant donor sites,relatively concealed donor sites,no obvious scars in the donor site after surgery,and the appearance of the flap has recovered well.Thefoot function index(FFI)indicated that the patient's foot function
作者
王金晶
田琦
黄国宝
罗浩铭
WANG Jinjing;TIAN Qi;HUANG Guobao(Department of Burn and Plastic Surgery,Center Hospital Affiliated To Shandong First Medical University,Jinan,Shandong,250013,China)
出处
《实用手外科杂志》
2023年第1期28-32,共5页
Journal of Practical Hand Surgery
