游离股前外侧皮瓣联合负压封闭引流修复足底皮肤缺损  

Clinical Effects of Free Anterolateral Thigh Flap Combined with Vacuum Sealing Drainage in Repairing Plantar Skin Defect

作　　者：袁长勇 刘洪全 刘跃廷 安长学 YUAN Changyong;LIU Hongquan;LIU Yueting;AN Changxue(Department of Hand Microsurgery,Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine,Panzhihua 617000,Sichuan,China)

机构地区：[1]攀枝花市中西医结合医院手显微外科,四川攀枝花617000

出　　处：《中国美容医学》2022年第12期8-12,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:研究游离股前外侧皮瓣(Anterolateral thigh flap,ALTF)联合负压封闭引流(Vacuum sealing drainage,VSD)修复足底皮肤缺损的临床效果。方法:选择医院2017年3月-2020年8月诊治的109例足底皮肤缺损患者,随机数表法分为研究组(55例)和对照组(54例),研究组给予VSD联合游离ALTF修复治疗,对照组给予常规换药后游离ALTF修复治疗。比较两组创面愈合时间、住院时间和手术前后创面疼痛程度、足踝功能情况和皮瓣感觉恢复情况,并观察术后足外观以及并发症情况。结果:术前两组疼痛评分比较差异无统计学意义(P>0.05);术后24 h、3 d、7 d研究组评分均显著低于对照组,且研究组创面愈合时间和住院时间均显著低于对照组,差异有统计学意义(P<0.05)。研究组瘢痕颜色和平整度评分及瘢痕宽度均显著低于对照组,差异有统计学意义(P<0.05);但两组弹性程度评分比较差异无统计学意义(P>0.05)。术前两组足踝功能评分比较差异无统计学意义(P>0.05);术后3个月、6个月研究组评分均显著高于对照组,差异有统计学意义(P<0.05)。术后3个月研究组皮瓣感觉恢复情况显著优于对照组,差异有统计学意义(P<0.05);但术后6个月两组皮瓣感觉恢复情况比较差异无统计学意义(P>0.05)。研究组并发症总发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:游离ALTF联合VSD应用于足底皮肤缺损修复中可减轻患者疼痛,减少并发症发生,有利于足外观、皮瓣感觉功能以及足踝功能的恢复。Objective To study the clinical eff ects of free anterolateral thigh flap(ALTF)combined with vacuum sealing drainage(VSD)in repairing plantar skin defect.Methods 109 patients with plantar skin defects diagnosed and treated in the hospital were selected as study subjects between March 2017 and August 2020.They were divided into the study group(55 cases)and the control group(54 cases)by random number table method.The study group was treated by VSD combined with free ALTF repair,while the control group was treated by free ALTF repair after conventional dressing change.The wound healing time,hospitalization time,the degree of wound pain before and after operation,the function of foot and ankle and the recovery of skin fl ap sensation were compared between the two groups,and the foot appearance and complications after operation were observed.Results There was no signifi cant diff erence in pain scores between the two groups before operation(P>0.05).24 h,3 d and 7 d after operation,the scores of the study group were signifi cantly lower than those of the control group,the wound healing time and hospital stay of the study group were signifi cantly shorter than those of the control group,the diff erences were statistically signifi cant(P<0.05).The scores for scar color,fl atness and scar width were also signifi cantly lower than those of the control group(P<0.05).But there was no signifi cant diff erence between the two groups in the scores of elasticity(P>0.05).Before operation,there was no significant difference between the two groups in ankle function scores(P>0.05).3 months and 6 months after operation,the scores of the study group were signifi cantly higher than those of the control group(P<0.05).3 months after operation,the sensory recovery of skin fl aps in the study group was signifi cantly better than that in the control group(P<0.05).But there was no signifi cant diff erence between the two groups in sensory recovery 6 months after operation(P>0.05).The incidence of complications in the study group was signifi

关 键 词：股前外侧皮瓣 负压封闭引流 足底皮肤缺损 感觉恢复 足踝功能 

分 类 号：R622[医药卫生—整形外科]