摘要
目的探讨腓肠神经营养血管逆行岛状皮瓣治疗小腿远端及足踝部软组织缺损的临床效果。方法第三军医大学第一附属医院整形美容外科2010年5月至2016年1月对34例患者行改良的腓肠神经营养血管逆行岛状皮瓣移植(观察组),并以12例外伤后仅用局部皮瓣转移覆盖创面的患者为对照(对照组),评定2组患者术后存活情况、并发症、功能恢复、局部感觉等临床效果。结果行改良的腓肠神经营养血管逆行岛状皮瓣移植的34例患者移植皮瓣全部成活,有3例出现皮瓣远端边缘部分坏死,经换药后痊愈,有3例患者创面出现少量张力性水泡,经勤换药处理后创面完全愈合。采用局部皮瓣转移覆盖的12例患者局部皮瓣全部存活,6个月后复查出现不同程度瘢痕挛缩、皮瓣变形、皮瓣萎缩等,而采用改良方式手术的患者术后功能、局部感觉、瘢痕大小等均明显优于后者,2组比较差异有统计学意义(P<0.05)。结论腓肠神经营养血管逆行岛状皮瓣修复远端创面,可成为能负重及耐磨的带感觉皮瓣,此法是目前值得推广的下肢足踝部缺损修复方法之一。
Objective To explore the clinical application of treating severe soft tissue defect on distal leg and foot with sural nerve nu trient vessels retrograde island flap. Methods A total of 34 cases of patients who were treated with sural nerve nutrient vessels retrograde is- land flap were regared as the observation group, and the other 12 cases who were treated with local rotation skin flap grafting were regared as the control group. The postoperative survival rate of skin flap, complications, functional recovery and local sensation of the two groups were e- valuated. Results The transplanted skin flap of the observation group all survived after operation. There were 3 cases of partial necrosis of the skin flap distal edge which were cured with dressing change. A few tension vesicle occured in 3 patients and they were cured with dressing change. The transplanted skin flap of the control group all survived after operation, but there were different degree of scar contracture, flap de- formation and flap atrophy 6 months after surgery. The postoperative function, local sensation, scar size of the observation group were better than those of the control group with statistically significant difference （P 〈 0.05 ）. Conclusion To treat severe soft tissue defect on distal leg and foot with sural nerve nutrient vessels retrograde island flap is a good method which can promote severe tissue defect repair on the lower extremity and foot.
作者
朱晓浩
陈卓
王雪丽
马昕
谈希
王珍祥
ZHU Xiao-hao CHEN Zhuo WANG Xue-li MA Xin TAN Xi WANG Zhen-xiang(Quanmei Medical Cosmetic Center, Wuhan Hubei 430000, China Department of Plastic and Aesthetic Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China)
出处
《局解手术学杂志》
2017年第8期620-623,共4页
Journal of Regional Anatomy and Operative Surgery
基金
国家自然科学基金面上项目(81272102)
重庆市应用开发项目(cstc2014yykf A110015)
关键词
岛状皮瓣
逆行
腓肠神经
组织缺损
修复
island flap
retrograde
sural nerve
tissue defect
repair
