穿支及筋膜皮瓣在小腿远端和足部难愈性创面修复中的应用  

Application of Perforator and Fasciocutaneous Flaps in Repairing Difficult Wounds of Distal Leg and Foot

作　　者：许祺琨[1] 杜永军[1] 李进[1] XU Qikun;DU Yongjun;LI Jin(Department of Plastic SurgeryⅡ,the First People’s Hospital of Foshan,Foshan City,Guangdong Province 528000)

机构地区：[1]广东省佛山市第一人民医院整形美容二科,528000

出　　处：《医学理论与实践》2021年第13期2193-2197,共5页The Journal of Medical Theory and Practice

摘　　要：目的:考察穿支及筋膜皮瓣在小腿远端和足部难愈性创面修复中的应用可行性及效果。方法:选取2008年1月—2018年12月在我院接受远端1/3小腿以及足踝部难愈性创面修复重建的54例患者,其中,行胫后动脉穿支皮瓣修复17例(31.5%),行腓动脉穿支皮瓣修复8例(14.8%),行腓肠肌皮瓣修复13例(24.1%),行足底内侧动脉岛状皮瓣修复4例(7.4%),行交叉腿皮瓣修复12例(22.2%)。结果:行胫后动脉穿支皮瓣修复患者中发生1例脂肪坏死,经多次换药后成功愈合,行腓肠肌皮瓣修复患者中发生1例边缘坏死,经清创后采用保守治疗愈合,行交叉腿皮瓣修复患者中发生1例皮瓣远端坏死,其余病例皮瓣均完全成活。结论:采用穿支及筋膜皮瓣修复小腿远端和足部难愈性创面是可行的,绝大部分患者皮瓣存活满意。Objective:To investigate the feasibility and effect of perforator and fasciocutaneous flaps in the repair of refractory wounds in the distal leg and foot.Methods:From January 2008 to December 2018,54 patients who underwent repair and reconstruction of one third of distal leg and ankle wounds were selected.17 patients(31.5%)underwent posterior tibial artery perforator flaps,8 patients(14.8%)underwent peroneal artery perforator flaps,13 patients(24.1%)underwent gastrocnemius myocutaneous flaps,4 patients(7.4%)were repaired with medial plantar artery island flaps and 12 patients(22.2%)were repaired with cross leg flaps.Results:1 case of fat necrosis occurred in the patients treated with perforator flaps of posterior tibial artery,1 case of edge necrosis occurred in the patients treated with gastrocnemius myocutaneous flaps,1 case of distal necrosis occurred in the patients treated with cross leg flaps after debridement,and the other flaps survived completely.Conclusion:It is feasible to use perforator and fasciocutaneous flaps to repair the refractory wounds of the distal leg and foot.The survival of the flaps in most patients is satisfactory.

关 键 词：小腿远端 足部 难愈性创面 穿支及筋膜皮瓣 修复 

分 类 号：R622[医药卫生—整形外科]