负压封闭引流联合腓骨短肌肌瓣修复慢性创伤后跟骨骨髓炎  

Vacuum sealing drainage comebined with peroneus brevis muscle flap to repair chronic post-traumatic calcaneal osteomyelitis

作　　者：罗丹 林忠莲 黄雅茹 王鹏 邓建文 王家亮 苏胜年 叶以铨 LUO Dan;LIN Zhonglian;HUANG Yaru;WANG Peng;DENG Jianwen;WANG Jialiang;SU Shengnian;YE Yiquan(Sanming First Hospital Affiliated to Fujian Medical University,Sanming 365000,China)

机构地区：[1]福建医科大学附属三明第一医院,福建三明365000

出　　处：《临床医药实践》2018年第3期163-165,共3页Proceeding of Clinical Medicine

基　　金：三明市科技计划项目(项目编号:2015-S-1)

摘　　要：目的:探讨负压封闭引流(VSD)联合腓骨短肌肌瓣修复慢性创伤后跟骨骨髓炎的方法与疗效。方法:选择收治的6例慢性创伤后跟骨骨髓炎患者,病程为3个月~2年,平均5个月。窦道及创面培养均为阳性。一期扩创后行VSD,二期切取逆行腓骨短肌肌瓣转移填塞。2例创口直接无张力拉拢缝合,3例在肌瓣上游离植皮,1例在肌瓣上行腓肠神经营养血管皮瓣转移修复。术前3天及术后10~14 d持续使用敏感抗生素。结果:6例创面均愈合。术后随访2个月~1年,创面未溃烂,骨髓炎未复发。6例患者稍有患侧跛行但均能弃拐下地负重行走。结论:VSD联合腓骨短肌肌瓣修复慢性创伤后跟骨骨髓炎技术相对简单,操作方便,效果较好。Objective:To discuss the methods and treatments of vacuum sealing drainage(VSD)comebining peroneus brevis muscle flap to repair chronic post-traumatic calcaneal osteomyelitis.Methods:Six cases of chronic traumatic heel osteomyelitis was choosed to treat6patients,osteomyelitis withing2years,and more than3months,the average course of it is5months.The growth and wound surface showed positive.One-staged wound reconstruction,second-staged cutting retrograde peroneus brevis muscle flap to ram.Two cases′wound surface lose power to directly suture.3cases had free skin grafting on the muscle flap.1case had sural neurovascular flap to repair.They continue to use sensitive antibiotics3days before sugery and10~14days after sugery.Results:The wound surface of these6caes all coalescenced.Post-operation follow-up from two months to one year,6months as average,no wound surface festered with no osteomyelitis recrudesce.Six cases sufered slightly Side limp,but still can do loaded walking.Conclusion:The skills of VSD comebined Peroneus brevis muscle flap to repair Chronic post-traumatic calcaneal osteomyelitis are relatively simple,can be conduct conviniently with good effect.

关 键 词：负压封闭引流 腓骨短肌肌瓣 跟骨骨髓炎 创面修复 

分 类 号：R681.2[医药卫生—骨科学]