游离移植腓肠内侧动脉穿支皮瓣修复手足感染性软组织缺损临床疗效分析  

Free transplanted medial sural artery perforator flap for repair of hand-foot infectious soft tissue defects

作　　者：孙克理 尹大海 董其强 王海康 Sun Keli;Yin Dahai;Dong Qiqiang;Wang Haikang(Department of Traumatic Orthopedics,Zhengzhou Renji Hospital,Zhengzhou450000,China)

机构地区：[1]郑州仁济医院创伤骨科,郑州450000

出　　处：《创伤外科杂志》2024年第2期126-129,共4页Journal of Traumatic Surgery

摘　　要：目的探讨游离移植腓肠内侧动脉穿支皮瓣修复手足中小感染性软组织缺损的方法和临床疗效。方法回顾性分析2019年1月—2022年6月郑州仁济医院收治手足感染性软组织缺损创面采用游离移植腓肠内侧动脉穿支皮瓣修复患者11例,男性8例,女性3例;年龄31~55岁,平均35.4岁。压砸伤6例,机器挤压伤3例,道路交通伤2例;足部7例,手部4例,皮瓣切取面积4.0 cm×5.5 cm~6.0 cm×13.0 cm。结果患者均获6~18个月随访,平均9.5个月,皮瓣外观及弹性良好,供区线性瘢痕。皮瓣全部成活;术后远端皮缘坏死1例,经局部扩创、换药后愈合;皮瓣出现静脉血管危象2例,经患肢抬高、局部按摩和拆除部分缝合线后好转,感染性创面均得到控制和修复。结论腓肠内侧动脉穿支皮瓣具有血管解剖位置恒定,血运可靠、切取简便,供区隐蔽的特点,利于感染创面的控制,是修复手足感染性软组织缺损的良好选择,值得临床中推广应用。Objective To investigate the method and clinical effect of free transplanted medial sural artery perforator(MSAP)flap in the repair of hand-foot soft tissue defects with median or mild infection.Methods A retrospective study was conducted on 11 patients with infected wounds on hands or feet,which were repaired by free transplanted MSAP flaps in Zhengzhou Renji Hospital,from Jan.2019 to Jun.2022.There were 8 males and 3 females aged 31-55(mean,35.4)years,with 6 cases due to crush injuries by objects,3 cases due to crush injuries by machine,and 2 cases due to road traffic accidents.Among them,7 cases involved the foot and 4 the hand.The size of the flap was 4.0 cm×5.5 cm to 6.0 cm×13.0 cm.Results All the 11 cases were followed up for 6-18(mean 9.5)months,which revealed good appearance and elasticity,and linear scar in the donor area.All flaps survived.One case developed distal skin margin necrosis after operation,which healed after local re-debridement and dressing change;2 cases had venous crisis,which was improved after elevation of the affected limb,local massage and removal of partial sutures.All the infectious wounds were controlled and repaired.Conclusion The MSAP flap has the advantages of constant vascular anatomical position,reliable blood supply,easy harvest and conceal donor site,which is a good choice for repairing infectious soft tissue defects at hands or feet with a good control effect and is worthy of wide promotion.

关 键 词：软组织缺损 腓肠内侧动脉 穿支皮瓣 感染性创面 游离移植 

分 类 号：R658[医药卫生—外科学]