逆行腓肠神经营养血管皮瓣联合负压封闭引流术治疗足踝部创面的效果分析  

Effect analysis of retrograde sural neurovascular flap combined with vacuum sealing drainage in the treatment of foot and ankle wounds

作　　者：周祥国 ZHOU Xiang-guo(Department of Foot and Ankle Surgery,Xuzhou Mercy Hospital,Xuzhou 221000,China)

机构地区：[1]徐州仁慈医院足踝外科,221000

出　　处：《中国实用医药》2022年第16期78-80,共3页China Practical Medicine

摘　　要：目的分析逆行腓肠神经营养血管皮瓣联合负压封闭引流术治疗足踝部创面的临床效果。方法67例足踝部创面患者,随机分为对照组(33例)和观察组(34例)。对照组实施逆行腓肠神经营养血管皮瓣治疗,观察组在对照组基础上联合负压封闭引流术治疗。对比两组患者治疗前后踝关节功能及皮瓣恢复效果、相关指标(手术准备时间、换药次数、住院时间及抗生素使用时间)。结果治疗前,两组患者踝关节功能评分对比差异无统计学意义(P>0.05);治疗后2、4周,观察组患者踝关节功能评分分别为(72.64±1.64)、(87.49±2.40)分,均高于对照组的(68.95±2.49)、(81.64±3.20)分,差异具有统计学意义(P<0.05)。观察组患者创面感染、皮瓣坏死、创面臃肿发生率分别为0、2.94%、5.88%,显著低于对照组的24.24%、24.24%、30.30%,差异具有统计学意义(P<0.05)。观察组患者手术准备时间(7.41±1.06)d、住院时间(15.42±1.97)d及抗生素使用时间(5.27±2.26)d均短于对照组的(14.60±1.50)、(25.60±2.16)、(10.69±3.19)d,换药次数(4.97±1.32)次少于对照组的(8.25±2.03)次,差异具有统计学意义(P<0.05)。结论对足踝部创面采用逆行腓肠神经营养血管皮瓣联合负压封闭引流术治疗能提升患者皮瓣恢复效果,改善创面感染情况,提升踝关节功能,临床可积极应用。Objective To analyze the clinical effect of retrograde sural neurovascular flap combined with vacuum sealing drainage in the treatment of foot and ankle wounds.Methods A total of 67 patients with foot and ankle wounds were randomly divided into the control group(33 cases)and the observation group(34 cases).The control group was treated with retrograde sural neurovascular flap,and the observation group was treated with vacuum sealing drainage on the basis of the control group.The ankle function before and after treatment,flap recovery effect,and related indicators(surgery preparation time,frequency of dressing change,hospitalization time,and antibiotic use time)were compared between the two groups.Results Before treatment,there was no statistically significant difference in ankle function scores between the two groups(P>0.05).At 2 and 4 weeks after treatment,the ankle joint function scores of the observation group were(72.64±1.64)and(87.49±2.40)points,which were higher than(68.95±2.49)and(81.64±3.20)points of the control group,and the differences were statistically significant(P<0.05).The incidence rates of wound infection,skin flap necrosis and wound swelling in the observation group were 0,2.94%,and 5.88%,which were significantly lower than 24.24%,24.24%,and 30.30%in the control group,and the differences were statistically significant(P<0.05).The surgery preparation time(7.41±1.06)d,hospitalization time(15.42±1.97)d and antibiotic use time(5.27±2.26)d in the observation group were all shorter than(14.60±1.50),(25.60±2.16),and(10.69±3.19)d in the control group,and the frequency of dressing changes(4.97±1.32)times was less than(8.25±2.03)times in the control group.All the differences were statistically significant(P<0.05).Conclusion The retrograde sural neurovascular flap combined with vacuum sealing drainage in the treatment of foot and ankle wound can not only effectively improve the recovery effect,improve the infection of the wounds and enhance the function of the ankle joint,which can be actively

关 键 词：逆行腓肠神经营养血管皮瓣 负压封闭引流术 足踝部创面 

分 类 号：R658.3[医药卫生—外科学]