外踝上穿支皮瓣修复足踝部软组织缺损的效果观察  

Effect of lateral malleolus perforator flap for the repair of soft tissue defect of foot and ankle

作　　者：谢长发 黄晓涛 方略 张弛 Xie Changfa;Huang Xiaotao;Fang Lue;Zhang Chi(Department of Orthopedics and Traumatology,the Traditional Chinese Medicine Hospital of Cixi,Cixi,Zhejiang 315300,China)

机构地区：[1]慈溪市中医医院骨伤科,浙江省慈溪315300

出　　处：《中国基层医药》2018年第21期2739-2742,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省宁波市科技项目（2012C50028）

摘　　要：目的观察外踝上穿支皮瓣修复足踝部软组织缺损的临床效果。方法选取慈溪市中医医院2012年1月至2015年12月收治的足踝部软组织烧伤患者36例为研究对象，创伤面积直径4～10 cm，均采用外踝上穿支皮瓣修复，其中外踝上后穿支皮瓣修复17例，前穿支皮瓣修复19例，皮瓣面积直径5～13 cm，观察修复效果。结果36例患者手术移植皮瓣均成活，7例产生平均直径为2.6 cm的淤血斑，2例产生小范围坏死，通过换药处理均治愈。随访6～12个月，移植皮瓣与原皮肤粘合正常，肤色、质地与周围皮肤相近。前穿支皮瓣修复的皮瓣成活时间、自主行走时间分别为（2.20±0.70）周、（4.70±1.10）周，长于后穿支皮瓣修复的（2.10±0.80）周、（4.20±1.10）周，但差异均无统计学意义（均P〉0.05）；前穿支皮瓣修复的美国矫形足踝协会（AOFAS）评分（77.47±3.41）分，明显低于后穿支皮瓣修复的（80.12±4.12）分，差异有统计学意义（t＝2.110，P〈0.05）。结论外踝上穿支皮瓣用于足踝部皮肤软组织缺损的修复有显著的效果，手术简便，成功率高。Objective To study the effect of lateral supramalleolar perforator flap for skin and soft tissue defect of lateral malleolus.Methods From January 2012 to December 2015, 36 patients with soft tissue burn of ankle in the Traditional Chinese Medicine Hospital of Cixi were selected as study objects.The average wound area was 4～10cm.The average flap size was 5～13cm.There were 17 cases received skin flap of behind perforator of the lateral malleolus.There were 19 cases received skin flap of front perforator of the lateral malleolus.The effect of repair was observed.Results All flaps survived in 36 cases after operation.There were 7 cases of 2.6cm of blood stasis, and necrosis occurred in 2 cases which healed after dressing change.Transplantation of skin flap and the original skin had good adhesion, skin color and texture was similar to the surrounding skin during the follow-up period of 6 to 12 months.The survival time and walk time of the repair of anterior perforator flap were （2.20±0.70）weeks, （4.70±1.10）weeks, respectively, which were longer than those of the lateral retromalleolar perforator flap[（2.10±0.80）weeks, （4.20±1.10）weeks], but the differences were not statistically significant （all P〉0.05）. The American orthopaedic foot and ankle society（AOFAS） score of the anterior perforator flap was significantly lower than that of the lateral retromalleolar perforator flap, the difference was statistically significant[（77.47±3.41）points vs.（80.12±4.12）points, t=2.110, P〈0.05].Conclusion Lateral supramalleolar perforator flap has significant effect for skin and soft tissue defect of lateral malleolus.The operation is simple, the success rate is high, it is worth to be popularized in clinical.

关 键 词：踝损伤 软组织损伤 外科皮瓣 修复外科手术 

分 类 号：R658.3[医药卫生—外科学]