隐神经营养血管蒂逆行岛状皮瓣修复足踝部骨外露的疗效分析  

Analysis of curative effect of reversed saphenous neurocutaneous island flap for foot and ankle bone exposure

作　　者：赵树林 张元昆 韩坤 王磊 Zhao Shulin;Zhang Yuankun;Han Kun;Wang Lei(Department of Orthopaedics,Jiaozhou People's Hospital,Jiaozhou 266300,China)

机构地区：[1]胶州市人民医院骨科,266300

出　　处：《国际医药卫生导报》2018年第23期3641-3644,共4页International Medicine and Health Guidance News

摘　　要：目的 观察隐神经营养血管蒂逆行岛状皮瓣修复足踝部骨外露的临床疗效。方法 选择2015年1—10月来本科治疗的足踝部软组织缺损患者25例,分别采用隐神经营养血管蒂逆行岛状皮瓣修复术(皮瓣修复组13例)和游离植皮术(植皮组12例)治疗。收集患者手术信息,术后随访6~12个月观察皮瓣血运情况、皮瓣温度以及综合疗效评估等,以此评估两种方法的优劣。结果 皮瓣修复组13例患者经1次手术全部成活,皮瓣面积最大13 cm×9 cm,最小7 cm×6 cm,皮瓣修复组的手术次数显著低于植皮组[(1.00±0.00)次比(2.50±0.74)次],皮瓣修复组患者的住院时间、住院费用显著优于植皮组住院时间([17.01±1.52)d比(24.52±1.61)d]、住院费用([8998.52±96.33)元比(19803.62±8337.25)元]。术后随访显示,皮瓣修复组皮瓣温度、皮瓣血运情况及综合疗效评估明显优于植皮组,差异有统计学意义(P<0.05)。结论 隐神经血管蒂逆行岛状皮瓣术治疗足踝部骨外露安全可靠,术后恢复快,值得临床推广应用。Objective To observe the clinical effect of reverse island skin flap pedicled with saphenous neurotrophic vessels in repairing the exposed foot and ankle bone.Methods Twenty-five patients with foot and ankle soft tissue defect who were treated in our department from January 2015 to October 2015 were selected and treated with reverse island skin flap pedicled by saphenous neurotrophic vessels(13 cases,skin flap repair group)and free skin graft(12 cases,skin graft group)respectively.The surgical information of the patients was collected and followed up for 6 to 12 months to observe the blood flow of the skin flap,the temperature of the skin flap,and the comprehensive efficacy,so as to evaluate the pros and cons of the two methods.Results All the skin flap in 13 patients of the skin flap repair group survived after one operation,with the largest flap area of 13 cm x 9 cm and the smallest flap area of 7 cm x 6 cm,the number of operations in the skin flap repair group was significantly lower than that in the skin graft group[(1.00±0.00)times vs.(2.50±0.74)times];and the length of hospital stay[(17.01±1.52)d]and the cost of hospital stay[(8 998.52±96.33)Yuan]in the skin flap repair group were significantly better than those in the skin graft group[(24.52±1.61)d,(19 803.62±8 337.25)Yuan].The postoperative follow-up showed that the temperature of skin flap,the blood flow of skin flap,and the comprehensive effect in the skin flap repair group were significantly better than those in the skin graft group,with statistically significant differences(P<0.05).Conclusion Retrograde island skin flap with saphenous nerve vessel pedicle is safe and reliable for the treatment of foot and ankle bone exposure.

关 键 词：隐神经血管蒂逆行岛状皮瓣术 软组织缺损 皮瓣温度 

分 类 号：R658.3[医药卫生—外科学]