带真皮的翻转筋膜瓣在小腿外伤后骨裸露创面修复中的应用  

Application of Fasciocutaneous Turnover Flap in the Reconstruction of Traumatic Defects with Exposed Bone in Lower Legs

作　　者：汤由之 成智[1] 葛小静[1] 朱喆辰 苏新[1] TANG Youzhi;CHENG Zhi;GE Xiaojing;ZHU Zhechen;SU Xin(Department of Plastic and Burn Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院整形烧伤科,江苏南京210029

出　　处：《中国美容医学》2024年第2期17-19,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨带真皮的翻转筋膜瓣在小腿外伤后骨裸露创面修复中的手术方法及术后效果。方法:选取2020年1月-2021年12月笔者医院收治的因外伤致胫腓骨开放性骨折伴骨裸露的12例患者,根据缺损部位、面积,设计带真皮的筋膜瓣,以翻转180°的方式修复小腿外伤后的复杂创面,观察患者治疗效果及术后随访情况。结果:本组11例患者皮瓣完全成活,1例患者皮瓣远端退缩伴少量骨裸露,经行对侧翻转筋膜瓣修复愈合。术后随访6~12个月,所有患者下肢外观及功能恢复良好。结论:带真皮的翻转筋膜瓣修复小腿外伤后骨裸露创面可达到理想的外观和功能恢复,其具有设计灵活、操作简洁、对皮瓣利用度高等特点,可作为临床上小腿外伤后可靠的早期修复方式。Objective To discuss the surgical method and postoperative effect of fasciocutaneous turnover flap in repair of traumatic defects with exposed bone in crus.Methods A total of 12 patients with open tibiofibular fractures with exposed bone caused by trauma admitted to the author's hospital from January 2020 to December 2021 were selected.Proper fasciocutaneous flaps were precisely designed according to the size and location of the wounds.The reconstructive surgery was completed by a 180°turnover flap with skin transplantation.Assessment was made by the patient’s treatment effect and postoperative follow-up.Results 11 cases of turnover flaps survived completely.In 1 patient,a small amount of bone bared due to the distal retraction of the flap,and the wound was reconstructed by a symmetric turnover flap.The follow-up period ranged from 6 to 12 months and showed a desirable appearance and function of the lower extremities.Conclusion Application of fasciocutaneous turnover flap in repairing traumatic defects with exposed bone in lower legs can achieve the ideal appearance and function recovery.It has the characteristics of flexible design,simple operation,and high utilization of the donor flap,which can be used as a reliable early repair method after calf trauma in clinical practice.

关 键 词：翻转筋膜瓣 带真皮的筋膜瓣 小腿外伤 骨裸露 创面修复 

分 类 号：R622[医药卫生—整形外科]