跟外侧皮瓣修复跟后区域皮肤软组织缺损的临床效果  

Clinical effects of heel lateral flap in repair of skin and soft tissue defects at posterior heel region

作　　者：金文虎[1] 常树森[1] 魏在荣[1] 李海[1] 周健[1] 陈伟[1] 孙广峰[1] 唐修俊[1] 王波[1] Jin Wenhu;Chang Shusen;Wei Zairong;Li Hai;Zhou Jian;Chen Wei;Sun Guangfeng;Tang Xiujun;Wang Bo(Department of Burns and Plastic Surgery,the Affiliated Hospital of Zunyi Medical College,Zunyi 563003,China)

机构地区：[1]遵义医学院附属医院烧伤整形外科,563003

出　　处：《中华烧伤杂志》2019年第3期218-220,共3页Chinese Journal of Burns

基　　金：国家自然科学基金(81560315);贵州省科技计划项目(黔科合支撑﹝2017﹞2877).

摘　　要：目的探讨跟外侧皮瓣修复跟后区域皮肤软组织缺损的治疗效果。方法2007年9月—2016年4月,笔者单位收治跟后区域皮肤软组织缺损患者24例(男17例、女7例,年龄16~70岁),扩创后皮肤软组织缺损面积为3.0cm×2.0cm^5.0cm×4.0cm。采用跟外侧皮瓣修复,皮瓣面积为3.5cm×2.5cm^6.0cm×5.0cm,经宽松的皮下隧道转移到受区,供瓣区移植腹股沟区全厚皮片修复。观察皮瓣成活及患者随访情况。结果本组24例患者皮瓣均顺利成活,供、受区创面均愈合。本组患者随访6~24个月,末次随访时皮瓣外形良好,色泽接近正常,质地柔软;皮瓣感觉S3级6例、S3+级18例,两点辨别觉距离6~11mm;足外侧区皮肤存在4.0cm×2.0cm^9.0cm×3.0cm范围感觉麻木。结论跟外侧皮瓣既能修复跟后区域皮肤软组织缺损,又能重建跟后区的感觉功能,是修复跟后区域皮肤软组织缺损的一种较为理想的方法。Objective To explore the clinical effects of heel lateral flap in repair of skin and soft tissue defects at posterior heel region. Methods From September 2007 to April 2016, 24 patients (17 males and 7 females, aged 16-70 years) with skin and soft tissue defects at posterior heel region were admitted to our department. The size of skin and soft tissue defects after debridement ranged from 3.0 cm×2.0 cm to 5.0 cm×4.0 cm. The defects were repaired with heel lateral flaps, with size ranging from 3.5 cm×2.5 cm to 6.0 cm×5.0 cm. The flaps were transferred to the donor sites through the loose subcutaneous tunnel. The donor site was repaired by full-thickness skin graft collected from inguinal region. The survival of flaps and the follow-up of patients were observed. Results All flaps of 24 patients survived successfully. The recipient sites and donor sites were all healed. The patients all had follow-up of 6 to 24 months. At the last follow-up, the flaps were in good shape, with nearly normal color and soft texture. There were 6 cases of grade S3 sensation and 16 cases of grade S3+ sensation. The distance of two-point discrimination of flaps ranged from 6 to 11 mm. The lateral foot skin grafts healed well, and the skin of the lateral foot was numb in the range of 4.0 cm×2.0 cm to 9.0 cm×3.0 cm. Conclusions Heel lateral flap can not only repair the skin and soft tissue defects in the posterior region, but also reconstruct the sensory function of the posterior region. It is an ideal method to repair the skin and soft tissue defects in the posterior region.

关 键 词：外科皮瓣 跟 软组织损伤 显微外科手术 跟外侧动脉 

分 类 号：R622[医药卫生—整形外科]