游离股前外侧皮瓣结合阔筋膜同时修复老年人足背皮肤及肌腱缺损  

Free anterolateral thigh flap transplanting combined with fascia lata simultaneously for the repair of foot dorsum tendon and skin defect in the senile people

作　　者：潘勇 朱辉 郑大伟 陈步国 石荣剑 寿奎水 PAN Yong;ZHU Hui;ZHENG Dawei(Department of Hand and Food Surgery,Renci Hospital of Xuzhou,Jiangsu,221004,China)

机构地区：[1]徐州仁慈医院手足显微外科,江苏徐州221004

出　　处：《实用手外科杂志》2018年第2期172-175,共4页Journal of Practical Hand Surgery

摘　　要：目的研究游离股前外侧皮瓣结合阔筋膜在修复老年患者足背皮肤软组织缺损伴肌腱缺损中的临床疗效。方法 2013年12月-2015年12月对30例老年足背皮肤软组织缺损、肌腱缺损患者,经急诊清创、外科换药等治疗,Ⅱ期应用游离股前外侧皮瓣修复创面的同时使用不带血运的阔筋膜编织缝合重建趾长伸肌腱、胫前肌腱,术后对皮瓣颜色、质地、感觉、足趾和踝关节活动等情况进行随访。结果皮瓣全部成活,无伤口感染、肌腱液化、脂肪液化,全部病例经12～36个月随访,皮瓣外形、色泽及质地均较满意,穿鞋自如,无垂足、垂趾发生,皮瓣恢复部分保护性感觉。按照Baird-Jackson踝关节功能评分标准:优25例,良4例,可1例,优良率为96.6%。结论应用游离股前外侧皮瓣修复老年人足背皮肤软组织缺损的同时采用不带血运的阔筋膜重建趾长伸肌腱、胫前肌腱,疗效满意,是修复老年患者足背皮肤软组织缺损、肌腱缺损的有效方法 。Objective To study the method and effect of free anterolateral thigh flap combined with fascia lata to repair foot dorsum skin, soft tissue and tendon defect in senile patients. Methods From December 2013 to December 2015, 30 cases of senile patients with foot dorsum skin, soft tissue and tendon defect were treated with emergency debridement, surgical dressing and other treatment. In the second stage, using the method of free anterolateral thigh flap and at the same time with the method of fascia lata without blood supply an reconstruct halluces longus and anterior tibial tendon. After operations, the skin color, texture, sensation, toe and ankle joint activities were followed-up. Results All flaps survived, no wound infection, tendon liquefaction and fat liquefaction occured. After 12 to 36 month＇s follow-up, all cases of flap appearance, color and texture were satisfactory. Wearing shoes freely, no foot and toe proses, the flap recovered part of the protective feeling. According to ankle Baird-Jack son score criteria, the result was excellent in 25 cases, good in 4 cases, and fair in 1 case, with the excellent-good rate of 96.6%. Conclusion The method of using free anterolateral thigh flap to repair the senile foot dorsum skin and soft tissue defect, at the same time with the method of fascia lata without blood supply to reconstruct hallucis longus and anterior tibial tendon has satisfactory effects. This method is effective in repairing the dorsal skin of senile patients with soft tissue defect and tendon defect.

关 键 词：老年患者 足背皮肤缺损 游离股前外侧皮瓣 阔筋膜 

分 类 号：R658.3[医药卫生—外科学]