股前外侧嵌合穿支皮瓣修复糖尿病足溃疡创面  

Repair of diabetic foot ulcer wound by anterolateral thigh chimeric perforator flap

作　　者：蒋玲丽 李海 魏在荣 曾可为 周健 聂开瑜 李书俊 邓呈亮 金文虎 JIANG Lingli;LI hai;WEI Zairong;ZENG Kewei;ZHOU Jian;NIE Kaiyu;LI Shujun;DENG Chengliang;JIN Wenhu(Department of Burn and Plastic Surgery,The Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou Province 563000,China)

机构地区：[1]遵义医科大学附属医院烧伤整形外科,贵州遵义563000

出　　处：《中华显微外科杂志》2021年第2期141-145,共5页Chinese Journal of Microsurgery

基　　金：贵州省科技计划项目(黔科合平台人才([2017]5733-012));黔科合平台人才([2020]5012);黔科合支撑([2017]2877);贵州省科技厅联合基金(黔科合成果2019(4441号));黔科合LH字([2017]7117号);遵义市科技计划项目(遵市科人才[2018]9号)。

摘　　要：目的:探讨股前外侧嵌合穿支皮瓣对糖尿病足溃疡(DFU)创面修复的临床疗效。方法:2018年1月至2019年12月,共收治14例Ⅱ型糖尿病足部溃疡,男10例,女4例,年龄49~58岁。其中单纯周围神经病变10例,周围神经病变合并血管病变4例,无单独血管病变患者。在严格控制患者血糖的基础上,对Wagner 2级以上DFU进行清创后抗生素骨水泥覆盖或填充,2~3周后采用股前外侧嵌合穿支皮瓣移植修复,皮瓣大小8 cm×3 cm~27 cm×7 cm。术后定期随访。结果:术后13块皮瓣一期成活,1块发生静脉危象,积极探查后皮瓣完全成活。随访6~12个月,供区和受区愈合良好,皮瓣外形好,质地佳,功能恢复满意。结论:股前外侧嵌合穿支皮瓣可修复DFU创面,临床效果良好,能有效改善患者生存质量。Objective To investigate the clinical effect of the anterolateral thigh perforator chimeric flap in the treatment of the wound of diabetic foot ulcer(DFU).Methods From January,2018 to December,2019,14 cases wound of DFU of type II diabetic were treated by anterolateral thigh chimeric perforator flap.The patients were 10 males and 4 females,at 49 to 58 years old.Of the 14 patients,10 with simple peripheral neuropathy,4 with peripheral neuropathy complicated with vascular disease,and none with single vascular disease.With strict control of patients'blood glucose,antibiotics blended bone cement was applied or filled onto grade 2 or higher grade Wagner's DFU after debridement.In addition,the anterolateral thigh chimeric perforator flap was transferred 2 to 3 weeks later.The size of flap was 8 cm×3 cm-27 cm×7 cm.Regular followed-up were made after surgery.Results Thirteen flaps survived in one stage after surgery.The other 1 flap had venous vascular crisis,and survived completely after active exploration.The patients were followed-up for 6-12 months.All the flaps survived well in good shape and texture.The donor and recipient areas healed well.The functional recoveries of the DF were satisfactory.Conclusion Application of anterolateral thigh perforator chimeric flap in repair of the refractory wound of DF achieves a good clinical outcome and effectively improves the life quality of patients.

关 键 词：糖尿病足 溃疡 股前外侧穿支皮瓣 嵌合皮瓣 修复 

分 类 号：R658.3[医药卫生—外科学]