摘要
目的探讨修薄游离腓动脉穿支皮瓣修复跟踝部皮肤软组织缺损的临床效果。方法对16例跟踝部皮肤软组织缺损患者应用修薄游离腓动脉穿支皮瓣修复,皮瓣切取面积为5.0 cm×4.0 cm^20.0 cm×10.0 cm。供区创面直接拉拢缝合或植皮修复。末次随访,以AOFAS踝-后足评分标准(优:90~100分;良:75~89分;可:50~74分;差:50分以下)及VAS疼痛评分标准(0分无疼痛;3分以下,有轻微疼痛,能忍受;4~6分患者感觉术区疼痛,并影响睡眠,尚能忍受;7~10分患者有渐强烈疼痛,难以忍受,影响食欲及正常睡眠)分别评估患足功能及生活质量。结果 16例患者的皮瓣均一期成活,切口愈合良好,供瓣区切口均愈合良好,移植皮片一期成活;随访6~18个月,跟踝部外观较满意,穿鞋不受影响,无明显的皮瓣挛缩及瘢痕增生。结论采用修薄游离腓动脉穿支皮瓣修复跟踝部皮肤软组织缺损,具有血供可靠、皮瓣成活率高、皮瓣感觉良好、走路无影响、外观较理想的效果,值得临床推广。
Objective To explore the clinical effect of the thin free repair of the peroneal artery perforator flap with ankle skin and soft tissue wounds. Methods Sixteen patients with ankle skin and soft tissue defects underwent application of thin free peroneal artery perforator flap repair with the ankle skin and soft tissue defect wounds. The maximum flap area incision was 20.0 cm×10.0 cm, and the minimum area was 5.0 cm × 4.0 cm. Donor site wounds were directly sutured or repaired by skin grafts. Final follow-up was made using the AOFAS ankle hindfoot scale（excellent： 90-100, 75-89; good： 50-74; poor： below 50）, as well as the VAS pain scale. To interpret this scale, a score of 0 meant no pain; a score of below 3 points meant slight painj; a score of 4-6 meant a slight tolerable pain with a sense of the operation area and tolerable pain with sleep; a score of 7-10 meant patients have gradually strong, unbearable pain, that affected the appetite and normal sleep. All patients were assessed with full function and quality of life. Results Skin flaps survived in all sixteen patients and the incision healed well. The donor sites healed well and skin grafts survived. Patients were followed up for 6 to 18 months, after which the appearance of the ankle was satisfactory. Use of shoes was not affected, and no obvious contracture or scar flap occurred. Conclusion Repair of the skin and soft tissue defect of the ankle with good flap texture, no influence on step or gait, satisfactory appearance,and ideal clinical results.
作者
杨明
赵雄
池征璘
YANG Ming ZHAO Xiong CHI Zheng-lin(Department of Plastic Surgery, The Children＇s Hospital Zhejiang University School of Medicine, Hangzhou 310000, China)
出处
《中国美容整形外科杂志》
CAS
2017年第10期599-601,共3页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
穿支皮瓣
跟踝部
皮肤软组织缺损
Perforator flap
Ankle
Skin and soft tissue defects
