应用顺行和逆行足背皮瓣修复小腿和足部创面  

Application of anterograde and reverse dorsalis pedis skin flap for repairing defects in the lower leg and foot

作　　者：杜轩宇 陈勇 王倩[1] 王慜 袁斯明 DU Xuanyu;CHEN Yong;WANG Qian;WANG Min;YUAN Siming(Department of Plastic Surgery,Jinling Hospital,School of Medicine,Southeast University,Nanjing 210002,China)

机构地区：[1]东南大学医学院附属金陵医院(东部战区总医院)烧伤整形科,江苏省南京市210002

出　　处：《组织工程与重建外科》2023年第4期371-375,共5页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：东部战区总医院2021年度院级课题(YYZD2021001)。

摘　　要：目的探讨应用顺行和逆行足背皮瓣修复小腿和足部创面的效果。方法回顾性分析我科2018年1月至2021年12月采用足背皮瓣修复的软组织缺损病例14例,其中9例采用顺行皮瓣,5例采用逆行皮瓣。供瓣区直接植皮修复,或用人工真皮支架覆盖2~3周后植皮修复。结果皮瓣全部存活,一期愈合。供区植皮大部分存活,少部分皮片成活不佳,换药后愈合。随访皮瓣外观良好,直接植皮修复的供区外观欠佳,应用人工真皮支架+二期植皮修复的供区外观明显改善,足部功能正常。结论足背皮瓣是修复下肢及足部软组织缺损的可靠选择,应用人工真皮支架覆盖供区+二期植皮能明显提高供区植皮成活率并改善外观。Objective To explore the application of anterograde and reverse dorsalis pedis skin flap in the repair of the defects in the lower leg and foot.Methods From Jan.2018 to Dec.2021,14 cases of dorsalis pedis flap were used to repair the defects in the lower leg and foot,including 9 cases of anterograde dorsalis pedis skin flap and 5 cases of reverse dorsalis pedis skin flap.The donor site was repaired with skin graft directly or covered with artificial dermis followed by skin graft 2-3 weeks later.Results All flaps survived well with primary healing.Most of skin grafts survived and the residual wound healed with dressing change.In the follow-up period,the appearance of the flap was satisfactory.The appearance of donor sites repaired with artificial dermis and secondary skin graft were better than that repaired by skin graft only.Foot function recovered well.Conclusion Dorsalis pedis flap is a reliable choice for repairing defects in the lower leg and foot.The application of artificial dermis before skin graft can obviously increase the survival rate and improve the long-term appearance of donor site.

关 键 词：足背皮瓣 缺损 小腿 足 人工真皮 

分 类 号：R622[医药卫生—整形外科]