胫后动脉穿支岛状皮瓣修复小腿中下段皮肤缺损的临床效果研究  

Clinical Effect of Posterior Tibial Artery Perforator Island Flap in Repairing Skin Defect of Middle and Lower Leg

作　　者：欧阳容兰[1] 刘江涛 连丽娜[1] OUYANG Ronglan;LIU Jiangtao;LIAN Lina(Department of Burns and Plastic Surgery,the 910th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Quanzhou 362000,Fujian,China)

机构地区：[1]中国人民解放军联勤保障部队第910医院烧伤整形科,福建泉州362000

出　　处：《中国美容医学》2022年第1期16-19,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨胫后动脉穿支岛状皮瓣在小腿中下段皮肤缺损修复中的临床疗效。方法:对2016年6月-2020年1月笔者医院收治的31例小腿中下段皮肤缺损患者行胫后动脉穿支岛状皮瓣修复,缺损面积3 cm×4 cm~13 cm×15 cm,切取皮瓣面积4 cm×5 cm~14 cm×16 cm,观察患者治疗效果及术后随访情况。结果:本研究中术后28例皮瓣成活,创面Ⅰ期愈合,成活率90.32%,余3例皮瓣远端边缘部分坏死,经换药后创面Ⅱ期愈合。供区感染1例,对症处理后治愈,余30例均愈合良好。31例患者均获随访,随访时间12~21个月,平均随访时间15个月。随访结果皮瓣血运良好,色泽与周围皮肤相近,质地柔软,厚薄适中,外形无臃肿,供区无明显瘢痕挛缩,患肢功能均在8个月内恢复。结论:胫后动脉穿支岛状皮瓣,供血稳定,质地良好成活率高,且不牺牲胫后动脉主干、小腿深筋膜等组织,利于患肢功能恢复,是修复小腿中下段皮肤缺损的理想皮瓣,同时手术操作简单,适应证广,值得临床推广。Objective To explore the clinical effect of the posterior tibial artery perforator island flap in the repair of skin defects in the middle and lower leg.Methods Repairing 31 patients with skin defects in the middle and lower legs of our hospital with the posterior tibial artery perforaor island flap from June 2016 to January 2020.Results Total of 28 skin flaps in this group survived,the wounds healed by first intention,survival rate is 90.32%,the remaining 3 cases were necrotic at the distal edge of the flaps,the wounds healed by second order after dressing change.At the donor site,total of 1 case was infected,after symptomatic treatment,the remaining 30 All cases healed well.All 31 patients were followed up for 12 to 21 months,with an average follow-up time of 15 months.The follow-up results showed that the skin flap had good blood supply,its color was similar to the surrounding skin,its texture was soft,its thickness was moderate,its appearance was not bloated,the donor site scar had no obvious contracture,and the function of the affected limb was restored within 8 months.Conclusion The posterior tibial artery perforator island flap has stable blood supply,good quality and high survival rate without sacrificing the posterior tibial artery trunk,deep leg fascia and other tissues.It is beneficial to the recovery of affected limb function and is an ideal skin for repairing skin defects in the middle and lower leg.this flap repairing is simple to operate and has a wide range of indications,which is worthy of clinical promotion.

关 键 词：小腿中下段皮肤缺损 胫后动脉穿支 岛状皮瓣 修复 

分 类 号：R622.1[医药卫生—整形外科]