腓动脉螺旋桨穿支皮瓣修复小儿足跟部皮肤缺损  

Repair of children’s heel skin defects by peroneal artery propeller perforator flap

作　　者：姚恩洋 田野[2] YAO En-yang;TIAN Ye(Department of Hand,Fool and Ankle Microsurgery,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院手足踝显微外科,辽宁沈阳110004 [2]中国医科大学附属盛京医院脊柱关节外科,辽宁沈阳110004

出　　处：《中国美容整形外科杂志》2020年第7期409-411,I0007,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨腓动脉螺旋桨穿支皮瓣修复儿童严重轮辐伤致足跟部皮肤软组织缺损及跟腱外露的临床疗效。方法选取自2016年9月至2019年6月诊治的因足跟部严重轮辐伤导致足跟部跟腱外露及表面皮肤软组织缺损患儿15例,缺损面积为6.0 cm×3.0 cm^12.0 cm×10.0 cm。均采用腓动脉螺旋桨穿支皮瓣修复,术后定期随访观察皮瓣成活及愈合情况;治疗后6个月采用AOFAS评分系统评估足踝功能及美观程度。结果 15例患儿术后伤口均一期愈合,皮瓣成活,无感染、坏死等并发症发生;平均随访(8.26±3.14)个月,治疗效果较满意。治疗后6个月,足踝关节功能评估优12例(80%),良3例(20%);优良率为100%。患儿的创面愈合、皮瓣温度和颜色以及局部瘢痕外观评分分别为(1.52±0.26)(1.12±0.26)(1.52±0.26)和(1.05±0.28)分。结论采用腓动脉螺旋桨穿支皮瓣修复患儿足跟区皮肤软组织缺损及跟腱外露,术后足踝部功能恢复较佳,外观较满意,患肢感觉未受影响,是修复足跟部皮肤软组织缺损及跟腱外露的较好术式。Objective To explore the clinical efficacy of peroneal artery propeller perforator flap in the repair of children’s heel skin defects caused by severe spoke injury.Methods From September 2016 to June 2019,15 children with achilles tendon exposure and skin soft tissue defects caused by severe spoke injury were diagnosed and treated in our hospital.The area of defects ranged from6.0 cm×3.0 cm to 12.0 cm×10.0 cm.All children were repaired by peroneal artery propeller perforator flap.The survival and healing of the flap were observed during the follow-up after operation.The ankle function and aesthetic appearance were evaluated by AOFAS scoring system at 6 months after operation.Results All wounds healed in the first stage after operation.The flaps survived without infection,necrosis and other complications.The follow-up was an average of(8.26±3.14)months.The efficacy was satisfactory.At 6 months after treatment,12 cases(80%)of foot and ankle joint function were evaluated as excellent and 3 cases(20%)were good.The excellent and good rate was100%.The scores of wound healing,flap temperature,color and the appearance of local scar were(1.52±0.26)(1.12±0.26)(1.52±0.26)and(1.05±0.28).Conclusion The peroneal artery propeller perforator flap was a good procedure in the repair of children’s heel skin and soft tissue defects and achilles tendon exposure.The recovery of foot and ankle function after operation was good.The appearance was satisfactory and the sensation of affected limb was not affected.

关 键 词：腓动脉 螺旋桨皮瓣 穿支皮瓣 跟腱外露 儿童 

分 类 号：R726.5[医药卫生—儿科]