摘要
目的:探讨腓肠神经营养血管皮瓣加负压封闭、持续冲洗治疗开放性跟骨骨折并皮肤缺损的效果。方法:13例开放性跟骨骨折伴皮肤缺损患者,清创后固定骨折,采用腓肠神经营养血管皮瓣修复,覆盖创面,并将冲洗、引流管置入,接负压封闭引流,进行持续冲洗治疗。结果:13例患者创面均愈合,浅表感染2例,骨折延迟愈合3例,术后皮瓣全部成活,足跟部皮瓣外形良好,能够负重。随访6～12个月,13例患者踝关节功能优7例,良4例,优良率为84.6%,且患者在疼痛、功能、力线等方面的评分显著高于治疗前(P<0.05),术后患者的Bolher′s角、Gissane′s角、Perie′s角较治疗前显著改善(P<0.05)。结论:腓肠神经营养血管皮瓣移植并负压封闭、持续冲洗治疗开放性跟骨骨折,在迅速稳定骨折的同时,能安全有效地封闭创面,缩短创面修复时间,促进骨折愈合,减少并发症,其治疗方法操作简单,成功率高,疗效好。
Objective： sural nerve nutrient vessels with negative pressure seal,continuous flap flush with bone fractures and open treatment skin defect effect.Methods： 2003 ~ 2009 with bone fractures were treated with skin defect open 13 cases,after debridement,fracture fixation by sural nerve nutrient vessels of skin flap,and will cover the wound,washing,the tube,and then put into negative pressure drainage continuously flush,closed treatment.Results： 13 patients wound healing,are superficial infection in 2 cases,fracture delayed union in 3,all patients get six to 12 months（mean 10 months）,the follow-up after all flaps survived completely,sufficient with department flap,can shape good weight.Conclusions： sural nerve nutrient vessels of the flap grafting and negative pressure seal,continuous flush with bone fractures,open treatment in a swift and effective stable fractures,at the same time can safely and effectively closed wound,shorten the wound repair,promote the healing time,reduce the complications of the treatment,simple operation,high success rate and has good curative effect.
出处
《海南医学院学报》
CAS
2011年第10期1355-1357,共3页
Journal of Hainan Medical University
基金
海南医学院科研基金资助学报项目(0020110369)~~
关键词
跟骨
开放性骨折
皮瓣
负压封闭
持续冲洗
Heel bone
Open fractures
Flap
Negative pressure seal
Last flush
