腓肠神经营养血管蒂皮瓣与足底内侧皮瓣修复足跟部软组织缺损疗效对比  

Effect Comparison of Sural Nerve Nutrient Vascular Pedicle Flap and Medial Plantar Flap in Repairing Heel Soft Tissue Defects

作　　者：付永峰 王嘉欣[1] 单楠 张馨元 FU Yongfeng;WANG Jiaxin;SHAN Nan;ZHANG Xinyuan(Department of Burn Plastic and Aesthetic Surgery,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China;Department of Oncology,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院烧伤整形美容外科,河北秦皇岛066000 [2]秦皇岛市第一医院肿瘤科,河北秦皇岛066000

出　　处：《中国美容医学》2024年第8期56-59,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨并对比腓肠神经营养血管蒂皮瓣与足底内侧皮瓣修复足跟部软组织缺损的效果。方法:前瞻性选取笔者医院2018年8月-2022年3月收治的89例足跟部软组织缺损患者,按随机数字表法分为A组(n=45)与B组(n=44),A组采用腓肠神经营养血管蒂皮瓣修复,B组采用足底内侧皮瓣修复。对比两组手术情况、患足功能和感觉的恢复情况及皮瓣外观满意度。结果:B组的皮瓣切取移植时间短于A组、术中出血量少于A组(P<0.05),B组皮瓣完全成活率高于A组(P<0.05)。术后3个月时,两组美国足踝外科协会(AOFAS)踝-后足评分均较术前明显升高,且B组患者的AOFAS踝-后足评分较A组高(P<0.05);两组皮瓣完全成活患者的英国医学研究会(BMRC)感觉功能分级均在S2级及以上,且B组的BMRC感觉功能分级均优于A组(P<0.05);A组皮瓣外观满意度评分低于B组(P<0.05)。结论:针对创面长径≤8.0 cm的足跟部软组织缺损,足底内侧皮瓣修复较腓肠神经营养血管蒂皮瓣移植修复效果更好,不仅皮瓣成活率更高,且患者患足的关节功能及感觉恢复更好,手术时间更短,术中出血量更少。Objective To explore the effect of sural nerve nutrient vascular pedicle flap and medial plantar flap in repairing heel soft tissue defects.Methods 89 patients with heel soft tissue defects in the author's hospital were prospectively selected from August 2018 to March 2022,and were divided into group A(n=45)and group B(n=44)according to the random number table method.Sural nerve nutrient vascular pedicle flap was used for repair in group A,and medial plantar flap was used in group B.The surgical conditions,affected foot function,sensory recovery and satisfaction of skin flap appearance were compared between both groups.Results The time of skin flap removal transplantation in group B was shorter than that in group A,and the intraoperative blood loss was less than that in group A(P<0.05).The complete survival rate of skin flap was higher in group B than that in group A(P<0.05).At 3 months after surgery,the American Orthopedic Foot and Ankle Society(AOFAS)ankle-hindfoot score in both groups was significantly enhanced compared with that before surgery,and the AOFAS score in group B was higher than that in group A(P<0.05).The British Medical Research Council(BMRC)sensory function grading in the two groups of patients with complete skin flap survival was grade S2 and above,and the BMRC sensory function grading was better in group B compared to group A(P<0.05).score of skin flap appearance satisfaction in group A was lower than that in group B(P<0.05).Conclusion Medial plantar flap is more effective in repairing heel soft tissue defects with wound diameter≤8.0 cm compared with sural nerve nutrient vascular pedicle flap transplantation.It not only has a higher survival rate of skin flap,but also has better joint function and sensory recovery of affected foot,and it has shorter surgical time and less intraoperative blood loss.

关 键 词：足跟部 软组织缺损 腓肠神经 营养血管蒂皮瓣 足底内侧皮瓣 修复 

分 类 号：R622[医药卫生—整形外科]