迟延腓肠神经逆行皮瓣修复糖尿病患者小腿下段及足部创伤后组织缺损的临床效果观察  

Delayed the reverse sural fl ap for repairing post-traumatic tissue defects in the lower leg and foot

作　　者：胡骁骅 车可心 曹彤瑜 曹建坤 赵筱卓 黎明 陈忠 沈余明 Hu Xiaohua;Che Kexin;Cao Tongyu;Cao Jiankun;Zhao Xiaozhuo;Li Ming;Chen Zhong;Shen Yuming(Department of Burn,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院烧伤科,北京100035

出　　处：《中国医刊》2024年第10期1097-1101,共5页Chinese Journal of Medicine

基　　金：北京市自然科学基金-昌平创新联合基金(L234067)。

摘　　要：目的探索迟延腓肠神经逆行皮瓣修复小腿下段及足部创伤后组织缺损的临床效果。方法选取2013年5月至2023年12月在首都医科大学附属北京积水潭医院烧伤科应用迟延腓肠神经逆行皮瓣进行小腿下段及足部全层皮肤缺损创面修复的12例糖尿病患者,回顾性分析其临床治疗效果。结果12例患者共13个创面,均采用迟延腓肠神经逆行皮瓣进行修复。1个皮瓣完全坏死,创面经植皮愈合;1个皮瓣远端坏死,去除坏死部分、改变旋转点后创面愈合;1个皮瓣术后3d皮瓣缺血范围较大,放弃皮瓣转移;1个皮瓣远端表皮坏死,经换药愈合;其余9个皮瓣完全存活。结论迟延腓肠神经逆行皮瓣可提高皮瓣存活率,可能是糖尿病合并外周血管和/或神经病变患者创面修复的一种较为适宜的选择。Objective To explore the effect of delayed the reverse sural flap in repairing tissue defects in the lower leg and foot.Method Twelve diabetes patients suffering from soft tissue defects in the lower leg and foot were admitted to our hospital from May 2013 to December 2023,all wounds were repaired with delayed sural nerve flap.Result A total of 13 wounds in 12 patients were repaired using this surgical method.One flap completely necrotized,and the wound healed after skin grafting.One flap had distal necrosis,and after removing the necrotic part and changing the rotation point,the wound healed.One flap had a large ischemic area 3 days after surgery,and flap transfer was abandoned.One flap had distal epidermal necrosis,which healed after dressing change.The remaining 9 flaps survived completely.Conclusion Delayed the reverse sural flap can improve the survival rate of the flap,which may be a more appropriate choice for wound repair in diabetes patients with peripheral vascular and/or neuropathy.

关 键 词：糖尿病 伤口修复 皮瓣 皮瓣迟延术 

分 类 号：R587.1[医药卫生—内分泌] R628[医药卫生—内科学]