随意型反折筋膜皮下瓣治疗足部骨外露16例  

The Random Reflexio-adipofascial Flap for Repairing the Foot Tissue Defect with Bone Exposure

作　　者：宋学龙 李焕龙 孔祥龙 万超[1] 修玉才[1] SONG Xue-long;LI Huan-long;KONG Xiang-long;WAN Chao;XIU Yu-cai(The Center of Osteology,the 981th Hospital of Joint Logistic Support of Chinese People's Liberation Army,Chengde 067000,Hebei,China)

机构地区：[1]中国人民解放军联勤保障部队第九八一医院骨科中心

出　　处：《中国现代手术学杂志》2019年第4期304-306,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨利用随意型反折筋膜皮下瓣治疗足部骨外露的临床疗效。方法回顾性分析2015年5月~2018年5月我科收治的16例足部骨外露患者的临床资料,骨外露创面大小(1.5cm×2.0cm)^(3.0cm×4.5cm)。均采用随意型反折筋膜皮下瓣进行修复,观察一期愈合情况。 结果本组16例患者一期植皮5例,其余为1周后二期植皮。因血运不良皮瓣远端发生部分坏死2例,1例发生植皮边缘约0.5cm线状干性结痂,痂皮脱落后自然愈合。术后随访6~22个月。1例患者因反复从事体力劳动致创面破溃,其余患者创面外形及质地良好,活动无影响。结论随意型反折筋膜皮下瓣治疗足部骨外露效果确切,供区损伤小,无需二次整形,便于基层医院开展。Objective To discuss the clinical efficacy of the random reflexio-adipofascial flap for repairing the foot tissue defect with bone exposure.Methods The clinical data of 16 cases with the area of foot tissue defect and bone exposure ranged from(1.5 cm×2.0 cm)to(3.0 cm×4.5 cm)admitted from 2015 to 2018 were analyzed retrospectively.The random reflexio-adipofascial flap was applied to repair the bone exposure in all cases.Results There were 5 cases received the primary skin grafting,and 11 cases were secondary skin grafting after one week.The partial necrosis of distal end of the flap was found in 2 cases due to poor blood supply,and linear dry incrustation at the edge of 0.5 cm of the flap in one case and healed naturally after the scab fallen off.All cases were followed up for 6 to 22 months.One patient suffered from wound ulceration due to repeated physical work.The other patients achieved good activity restoration with satisfied appearance and texture.Conclusion The random reflexio-adipofascial flap is effective for repairing the tissue defect and bone exposure of foot with less damage to donor site and no need for secondary plastic surgery,and which is suitable for primary hospital.

关 键 词：筋膜皮下组织瓣 骨外露 足损伤 修复 

分 类 号：R622[医药卫生—整形外科]