摘要
目的探讨足底内侧联合足内侧皮瓣修复足底负重区缺损的临床效果。方法采用回顾性病例系列研究分析2020年3月至2022年3月遵义医科大学附属医院收治的12例足底负重区缺损患者临床资料,其中男9例,女3例;年龄27~62岁[(39.3±8.7)岁]。缺损部位为足掌缺损4例,足跟缺损8例。缺损面积为10 cm×8 cm~13 cm×12 cm。皮瓣切取面积11 cm×8 cm~14 cm×13 cm,其中5例采用游离皮瓣(4例足掌及1例足跟缺损),7例采用带蒂皮瓣(均为足跟缺损),皮瓣供区全部植皮修复。记录术后皮瓣成活情况。末次随访时,记录皮瓣外观、质地及两点辨别觉;采用Maryland足功能评分评价足的功能;通过双脚规测试重建皮瓣的两点辨别觉来评价重建皮瓣的感觉功能。结果患者均获随访6~24个月[(11.8±5.3)个月]。皮瓣全部成活。末次随访时,皮瓣外观无任何臃肿,无破溃,质地好、无滑动。末次随访时,Maryland足功能评分(92.8±7.2)分,较术前的(36.6±6.1)分明显增加(P<0.01),优9例,良3例。重建皮瓣的两点辨别觉为(17.8±5.7)mm,与对侧的(16.3±5.1)mm比较差异无统计学意义(P>0.05)。皮瓣感觉均恢复正常,皮瓣供区残留植皮后瘢痕,对足活动无明显影响。结论足底内侧联合足内侧皮瓣切取面积大、质地好,能够满足修复足底负重区的功能要求,术后感觉恢复好,是修复足底负重区缺损的较好选择。
Objective To investigate the clinical effect of combining medial plantar flap with medial foot flap for repairing weight‑bearing area defects of the foot.Methods A retrospective case series study was used to analyze the clinical data of 12 patients with weight‑bearing area defects of the foot,who were admitted to the Affiliated Hospital of Zunyi Medical University from March 2020 to March 2022.There were 9 males and 3 females,with the age of 27‑62 years[(39.3±8.7)years].There were 4 patients with palm defects and 8 with heel defects.The defect area ranged from 10 cm×8 cm to 13 cm×12 cm.The cutting area of skin flap ranged from 11 cm×8 cm to 14 cm×13 cm.A total of 5 patients were treated with free flaps(4 patients with palm and 1 with heel defects)and 7 with pedicled flaps(all with heel defects).The flap donor areas were repaired with skin grafting.The flap survival was observed after surgery.At the last follow‑up,the appearance,texture,and two point discrimination of the flap were recorded;the foot function was evaluated by Maryland foot function score;the sensory function of the reconstructed skin flap was evaluated by testing the two‑point discrimination using a bipedal gauge.Results The patients were followed up for 6‑24 months[(11.8±5.3)months],and all the flaps survived.At the last follow‑up,the flaps were free of any swelling and ulceration,with good texture and no sliding.The Maryland foot function score was(92.8±7.2)points at the last follow‑up,which was significantly higher than the preoperative(36.6±6.1)points(P<0.01),being excellent in 9 patients and good in 3.The two‑point discrimination of the reconstructed flap was(17.8±5.7)mm at the last follow‑up,and there was no significant difference compared with the contralateral(16.3±5.1)mm(P>0.05).The sensation of the flap returned to normal.There were residual scars in the flap donor area after skin grafting,but no significant impact on foot movement.Conclusion The medial plantar flap combined with medial foot flap has a large
作者
张弓雪
金文虎
张子阳
全辉
王达利
Zhang Gongxue;Jin Wenhu;Zhang Ziyang;Quan Hui;Wang Dali(Department of Burns and Plastic Surgery,Affiliated Hospital of Zunyi Medical University,Zunyi 563003,China;Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University,Zunyi 563003,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2023年第6期523-527,共5页
Chinese Journal of Trauma
基金
国家自然科学基金(82260392)
省部共建协同创新中心项目[教科技厅函(2020)39号]
遵义市科技计划项目[遵市科合HZ字(2021)12号]。
关键词
外科皮瓣
软组织损伤
足损伤
足底内侧动脉
Surgical flap
Soft tissue injuries
Foot injuries
Medial plantar artery
