3种足部带蒂皮瓣修复前足软组织深度缺损的疗效  

The effect of three pedicled flaps of the feet in repairing deep defect of forefoot soft tissue

作　　者：单国华 胡继燕 赵峰刚 马金猛 SHAN Guo-hua;HU Ji-yan;ZHAO Feng-gang;MA Jin-meng(Dept of Hand and Food Surgery,the 984th Hospital of Joint Logistic Support Force of CPLA,Beijing 100094,China)

机构地区：[1]中国人民解放军联勤保障部队第九八四医院手足外科,北京100094

出　　处：《临床骨科杂志》2023年第6期813-815,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨3种足部带蒂皮瓣修复前足软组织深度缺损的临床疗效。方法采用3种足部带蒂皮瓣修复12例前足软组织深度缺损患者,其中足底内侧动脉浅支穿支皮瓣5例,足背营养神经皮瓣4例,第1跖背动脉皮瓣3例。创面大小3.0 cm×2.0 cm~5.5 cm×4.0 cm。皮瓣大小3.5 cm×3.0 cm~6.0 cm×4.5 cm。结果患者均获得随访,时间3~6个月。皮瓣均完全成活,无血管危象、感染等并发症发生,创面一期愈合。末次随访时,患足外观良好,无局部溃疡发生,皮瓣色泽、质地良好,薄厚适中,足踝恢复正常的负重及行走功能,皮瓣两点辨别觉为7~11 mm;根据AOFAS评分标准评定踝关节功能:优9例,良3例。结论采用3种足部带蒂皮瓣修复前足软组织深度缺损,手术操作简单,皮瓣血供可靠,成活率高,足部外观和功能恢复良好。Objective To investigate the clinical effect of three pedicled flaps of the feet in repairing deep defect of forefoot soft tissue.Methods Twelve cases with deep defects of forefeet soft tissue were repaired by 3 pedicled flaps of the feet,including 5 cases with perforator flap of superficial branch of medial plantar artery,4 cases with nutrient nerve flap of dorsal feet and 3 cases with dorsal artery of first plantar.The wound area was 3.0 cm×2.0 cm~5.5 cm×4.0 cm.The flap area was 3.5 cm×3.0 cm~6.0 cm×4.5 cm.Results All patients were followed up for 3~6 months.All flaps survived completely,no complications such as vascular crisis and infection occurred,and the wound healed in one-stage.At the last follow-up,the affected foot had a good appearance,no local ulcers occurred,the skin flap had good color and texture,and the thickness was moderate.The foot and ankle returned to normal weight-bearing and walking function,and the two-point discrimination of the skin flap was 7~11 mm.Ankle joint function was evaluated according to the AOFAS scale criterion:9 cases were excellent and 3 cases were good.Conclusions Three pedicled flaps of the feet are used to repair the deep defect of forefoot soft tissue.The operation is simple,the flap blood supply is reliable,with high survival rate,good appearance and functional recovery of the foot.

关 键 词：转移皮瓣 足软组织缺损 显微外科修复 

分 类 号：R622.1[医药卫生—整形外科] R658.3[医药卫生—外科学]