足踝部皮肤软组织缺损游离皮瓣修复  

Free flap reconstruction of foot and ankle soft tissue defects

作　　者：单乐群[1] 马保安[1] 张勇[1] 郑联合[1] 李军[1] 王育才[1] 范清宇[1] 

机构地区：[1]第四军医大学唐都医院骨科,西安市710038

出　　处：《中华实用诊断与治疗杂志》2010年第2期119-120,124,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金资助项目(编号:30901784)

摘　　要：目的:探讨应用游离皮瓣移植修复足踝部皮肤软组织缺损的临床效果及预后。方法:应用股前外侧皮瓣、小腿外侧皮瓣游离移植修复足踝部皮肤软组织缺损,切取的皮瓣面积12cm×8cm～20cm×13cm,供区中厚或全厚皮片植皮修复。结果:19例踝周皮肤软组织缺损行游离皮瓣移植全部成活,1例在皮瓣修复的周围软组织挫伤区出现坏死、二期行膝内侧交腿皮瓣修复。术后随访6～12个月,皮瓣多显臃肿,4例行二期修整,无溃疡发生,感觉部分恢复,功能恢复良好。结论:在踝周无合适局部皮瓣或带蒂皮瓣转移修复的情况下,依据软组织缺损情况采用不同的游离皮瓣修复方法,可达到较好的外观和功能要求。Objective To discuss the effect and prognosis of the reconstruction with free flap for foot and ankle soft tissue defect. Methods Free grafting of anterolateral thigh flap or lateral leg flap were used to reconstruct foot and ankle defect. The area of the free flap was ranged from 12 cm×8 cm to 20 cm×13 cm. The donor sites were covered with split-thickness skin graft or full thick skin graft. Results All flaps but one survived. In the failed case,necrosis occurred in the contused soft tissue around the recipient site,and secondary reconstruction was carried out with cross leg medial genicular flap. The follow-up survey was done from 6 to 12 months. All the flaps appeared fat and clumsy. In 2 patients who underwent later debulking,no ulcer was observed,the sense of the recipient site was partially recovered and the function was well preserved. Conclusion If the local flap or pedicled flap is not suitable,free flaps can be adopted to reconstruct soft tissue defect of foot ankle.

关 键 词：足踝部 缺损 游离皮瓣 显微外科 

分 类 号：R658.3[医药卫生—外科学]