岛状皮瓣修复小腿中下段皮肤软组织缺损效果  

Repair of soft tissue defect of the middle and lower leg with island flap

作　　者：鄢巧玉 黎斌 Yan Qiaoyu;Li Bin(Department of Medical Cosmetology,Hangzhou Women's Hospital,Hangzhou 310008,China;Department of Hand and Foot Surgery,Shulan(Hangzhou)Hospital,Hangzhou 310015,China)

机构地区：[1]杭州市妇产科医院医学美容科,杭州310008 [2]树兰(杭州)医院手足外科,杭州310015

出　　处：《中华医学美学美容杂志》2023年第4期304-307,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的:探讨小腿中下段外伤骨折术后部分皮肤软组织坏死创面修复的方法和效果。方法:选择2015年12月至2018年12月,树兰(杭州)医院手足外科小腿中下段骨折术后出现皮肤软组织坏死的缺损创面患者22例,男17例、女5例;年龄21~53岁,平均35岁。用3种小腿部岛状皮瓣修复,其中腓肠神经营养筋膜蒂(肌)皮瓣修复9例、胫后动脉穿支皮瓣7例、腓动脉穿支皮瓣6例。创面缺损面积3.0 cm×3.8 cm~12.0 cm×9.0 cm,供区直接缝合或游离刃厚皮片游离植皮。结果:21例患者供区缝合创面及植皮均一期愈合,皮瓣均成活;1例患者腓肠神经营养筋膜蒂岛状肌皮瓣坏死。术后随访5~24个月,平均9个月;皮瓣质地良好,无溃疡、外观满意。结论:小腿部岛状皮瓣修复小腿中下段骨折术后部分皮肤软组织坏死缺失创面,是较理想的修复方式。Objective To investigate the methods and effect of wound repair after partial skin and soft tissue necrosis of middle and lower leg fracture surgery.Methods Three kinds of island flaps were used to repair the wound after skin and soft tissue necrosis of middle and lower leg fracture surgery in 22 patients.Nine patients were repaired with sural neurotrophic fascial flaps,7 patients with posterior tibial artery perforator flaps,and 6 patients with peroneal artery perforator flaps.The area of wound defect was 3.0 cm×3.8 cm to 12.0 cm×9.0 cm.The donor area was directly sutured,or free skin grafted.Results All patients were the cases after partial skin and soft tissue necrosis of middle and lower leg fracture surgery,with bone,internal fixation plate or tendon exposed.The skin flaps in 21 patients were survived,and the wound healed by first intention.The sural neurotrophic fascial flap necrosis in one patient was due to hematoma and entrapment in vascular pedicle.After 5 to 24 months(mean 9 months)follow-up,texture of flaps was good,no ulcer occured,and outlook of the repaired wound was satisfied.The sutured wound of donor site and skin-grafting had healed by first stage intention.Conclusions Repair with island flap is an ideal way to the defect wound after skin and soft tissue necrosis of middle and lower leg fracture surgery.

关 键 词：骨折 小腿 皮肤软组织坏死 岛状皮瓣 创面修复 

分 类 号：R687.3[医药卫生—骨科学]