显微削薄旋髂浅动脉穿支皮瓣修复成人足背侧创面

doi:10.3969/j.issn.1009-976X.2020.03.013

摘要/Abstract

摘要： 目的分析显微削薄旋髂浅动脉穿支皮瓣修复成人足背侧创面的临床效果。方法回顾性分析2014年至2017年滨州医学院附属医院收治的19例伴有骨骼或肌腱外露的足背侧创面患者的临床资料,均通过显微削薄旋髂浅动脉穿支皮瓣,一期或二期修复创面,供区直接缝合。结果所有患者均获得随访,平均随访1~5年,足背侧创面获得了有效修复;3例出现局部0.5~1 cm皮瓣边缘坏死,待坏死界线清楚以后切除坏死皮瓣,经重新缝合以后皮瓣愈合良好;1例出现皮瓣下方淤血,皮瓣肿胀,经间断拆线,清理淤血并充分引流以后皮瓣成活;1例出现动脉危象,给予急症手术,探查发现动脉吻合口长度约0.5 cm栓子,取出栓子并重新吻合动脉,皮瓣最终成活良好;足部外形美观,皮瓣柔软,厚薄适中;末次随访时AOFAS踝-后足评分为（91.02±1.74）,功能为优者14例（74%）,良者4例（21%）,AOFAS评分优良率95%,患肢功能恢复良好。结论应用显微削薄旋髂浅动脉穿支皮瓣修复成人足背侧创面,皮瓣外形美观,质地柔软,厚薄适中,可达到良好的临床效果。

关键词: 穿支皮瓣, 旋髂浅动脉穿支, 足背侧创面, 游离皮瓣

Abstract: Objective To analyze the clinical effect of uperficial circumflex iliac artery perforator superthin flaps in repair of soft tissue defect of dorsal foot in adults. Methods The clinical data of 19 cases of soft tissue defect of dorsal foot with bone or tendon exposure from 2014 to 2017 in the Affiliated Hospital of Binzhou Medical College were analyzed retrospectively,the soft tissue defect was repaired by uperficial circumflex iliac artery perforator superthin flap, primary or secondary defect repair,and the donor area was sutured directly. Results All the patients were followed up for an average of 1~5 years, and the soft tissue defect of dorsal foot was repaired effectively. 3 cases had local necrosis of 0.5~1 cm flap edge. After the necrosis boundary was cleared, the flap healed well through suturing again. 1 case had blood stasis under the flap, swelling of the flap, but the flap survived through intermittent suture removal, removal of congestion and full drainage. 1 case presented with arterial crisis, which emergency operation was performed. The embolus with a length of about 0.5 cm was found by exploration. The embolus was removed and the artery was anastomosed again, and the flap survived well.The skin flap was beautiful in appearance, soft in texture and suitable in thickness. At the last follow-up, the AOFAS ankle posterior foot score was （91.02 ± 1.74）, the function was excellent in 14 cases （74%）, good in 4 cases （21%）. The excellent and good rate of AOFAS was 95%, and the function of affected limb recovered well. Conclusion The uperficial circumflex iliac artery perforator superthin flap can be used to repair the soft tissue defect of dorsal foot in adults. The skin flap is beautiful in appearance, soft in texture and suitable in thickness, which can achieve good clinical effect.

Key words: soft tissue defect of dorsal foot, perforator flap, uperficial circumflex iliac artery perforator, free flap

中图分类号:

R628

付炳金, 杨佳林, 邓明明, 杜瑞, 孙广超, 尹刚. 显微削薄旋髂浅动脉穿支皮瓣修复成人足背侧创面[J]. 岭南现代临床外科, 2020, 20(03): 315-318.

FU Bing-jin, YANG Jia-lin, DENG Ming-ming, DU Rui, SUN Guang-chao, YIN Gang. Repair of soft tissue defect of dorsal foot in adults using uperficial circumflex iliac artery perforator superthin flaps[J]. Lingnan Modern Clinics in Surgery, 2020, 20(03): 315-318.

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