腓肠神经营养血管皮瓣在前足及踝部不同位置软组织缺损创面修复效果观察  

Observation of the repair effect of gastrocnemius neurovascular flap on soft tissue defects in different positions of the forefoot and ankle

作　　者：惠文文 高峰 HUI Wenwen;GAO Feng(Department of Orthopedics,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市中心医院骨科,河南南阳473000

出　　处：《中国医疗美容》2025年第2期51-55,共5页China Medical Cosmetology

摘　　要：目的观察腓肠神经营养血管皮瓣在前足及踝部不同位置软组织缺损创面修复中的应用效果。方法对127例2021年9月至2024年5月在南阳市中心医院用腓肠神经营养血管皮瓣修复的足踝部软组织缺损患者的临床资料进行回顾性分析。根据软组织缺损解剖位置不同,以跗跖关节为界,将跗跖关节以远端软组织缺损患者命名为前足组(49例),跗跖关节以近端软组织缺损患者命名为踝部组(78例),比较两组疗效,术后24 h、3 d、7 d皮瓣臃肿程度、皮表温度,皮瓣存活率,手术时间、术中出血量、住院时间等围手术期指标、Maryland足部评分。结果前足组总有效率为83.67%,低于踝部组96.15%,差异有统计学意义(χ^(2)=4.453,P=0.035)。术后24h,两组皮瓣臃肿程度、皮表温度差异无统计学意义(P>0.05),术后3 d、7 d前足组皮瓣臃肿程度高于踝部组,皮表温度低于踝部组,差异有统计学意义(P<0.05)。前足组皮瓣存活率为81.63%,低于踝部组94.87%,差异有统计学意义(χ^(2)=5.741,P=0.017)。前足组手术时间、术中出血量、住院时间等围手术期指标均高于踝部组,差异具有统计学意义(P<0.05)。术后3个月,踝部组患者足部感觉、足部功能、足部外观及Maryland足部评分总分均高于前足组,组间比较差异有统计学意义(P<0.05)。结论腓肠神经营养血管皮瓣可作为足踝部软组织缺损创面修复的理想皮瓣,具有良好的修复效果;随着与供皮区距离增加,前足远端部位皮瓣存活率有所下降。Objective Observation of the application effect of sural nerve nutritional vascular flflap in the repair of soft tissue defects in different positions of the forefoot and ankle.Methods A retrospective analysis was conducted on the clinical data of 127 patients with soft tissue defects in the ankle and foot area who underwent repair using the sural nerve nutritional vascular flflap in our hospital from September 2021 to May 2024.Based on the different anatomical locations of soft tissue defects,the tarsal joint was used as a boundary to name patients with distal soft tissue defects as the forefoot group(49 cases),and patients with proximal soft tissue defects as the ankle group(78 cases).The therapeutic effects of the two groups were compared,including the degree of flflap swelling,skin surface temperature,flflap survival rate,perioperative indicators such as surgery time,intraoperative blood loss,and hospital stay at 24 hours,3 days,and 7 days after surgery,as well as the Maryland Foot Score.Results The total effective rate of the forefoot group was 83.67%,which was lower than that of the ankle group at 96.15%,and the difference was statistically signifificant(χ^(2)=4.453,P=0.035).24 hours after surgery,there was no statistically signifificant difference in the degree of skin flflap swelling and skin surface temperature between the two groups(P>0.05).However,3 and 7 days after surgery,the degree of skin flflap swelling in the foot group was higher than that in the ankle group,and the skin surface temperature was lower than that in the ankle group,with statistical signifificance(P<0.05).The survival rate of the forefoot flflap group was 81.63%,which was lower than that of the ankle group(94.87%),and the difference was statistically signifificant(χ^(2)=5.741,P=0.017).The perioperative indicators such as surgery time,intraoperative blood loss,and hospital stay in the forefoot group were higher than those in the ankle group,and the difference was statistically signifificant(P<0.05).Three months after surgery,the an

关 键 词：腓肠神经营养血管皮瓣 软组织缺损 前足 足踝 修复 

分 类 号：R658.3[医药卫生—外科学]