摘要
目的回顾性分析不同年龄段小腿皮肤软组织缺损患者应用腓动脉穿支筋膜蒂皮瓣修复的临床资料。方法选取进行治疗的46例小腿皮肤软组织缺损患者进行研究,均采用远端蒂腓动脉穿支筋膜蒂皮瓣进行修复,根据患者年龄段将其分为儿童组(小于15岁)18例和成人组(大于15岁)28例。对患者进行术后随访,比较2组皮瓣修复效果、皮瓣存活情况、并发症影响因素以及供区并发症发生情况。结果2组修复效果、优良率差异均无统计学意义(P>0.05)。儿童组与成人组皮瓣完全存活率差异无统计学意义(P>0.05)。2组部分坏死和边缘坏死等并发症发生率差异亦无统计学意义(P>0.05)。2组性别比例、旋转点位置和近端位置差异均无统计学意义(P>0.05)。儿童组创面部位位于小腿下段前方的比例低于成人组,位于跟腱及踝区的比例高于成人组,差异有统计学意义(P<0.05)。儿童组轮辐伤的构成比高于成人组,而砸压伤、运动伤的比例低于成人组,差异有统计学意义(P<0.05)。2组受伤至手术时间差异无统计学意义(P>0.05)。2组色素沉着和感觉麻木发生率差异无统计学意义(P>0.05),儿童组皮肤瘙痒和瘢痕的发生率高于成人组,差异有统计学意义(P<0.05)。结论不同年龄段小腿皮肤软组织缺损患者应用腓动脉穿支筋膜蒂皮瓣均有较好的修复效果和存活情况,但儿童皮瓣供区发生皮肤瘙痒和瘢痕的概率更高。
Objective To retrospective analyze clinical data of different age repair crus skin soft tissue defects in patients with peroneal artery perforator fasciocutaneous flap.Methods The 46 patients with soft tissue defect of the leg were selected for the study,by using the distally based peroneal artery perforator fasciocutaneous flap repair. According to the age of the patients, they were divided into 18 cases in the children group（under 15 years old） and 28 cases in the adult group（over 15 years old）. The flap repair effect, flap survival and complication of donor site were compared between the two groups.Results The repair effect of the two groups were not statistically significant（ P 〉 0.05） compared with the rate of good. The complete survival rate of the flap in the children group was not statistically significant compared with the adult group（ P 〉 0.05）. There was no significant difference in the incidence of complications such as partial necrosis and marginal necrosis between the two groups（ P 〉 0.05）. There was no significant difference in sex ratio, location of rotation point and proximal position between the two groups（ P 〉 0.05）. The proportion of the wound site in the lower leg was lower than that in the adult group, and the proportion in the Achilles tendon and ankle region was higher than that in the adult group, the difference was statistically significant（ P 〈 0.05）. The proportion of spoke injury in children group was higher than that in adult group, but the proportion of crush injury and sports injury was lower than that of adult group, the difference was statistically significant（ P 〈 0.05）. There was no significant difference between the two groups in terms of injury to operation time（ P 〉 0.05）. There was no significant difference in the incidence of hyperpigmentation and sensory anesthesia between the two groups（ P 〉 0.05）. The incidence rate of skin itching and scar in children group was higher than that in adult group, the difference was statistically significant（ P 〈 0.05）.Conclusion Different ages of crus skin soft tissue defects in patients with peroneal artery perforator fasciocutaneous flap has good repairing effect and survival rate. However, the skin flap and donor site of skin flap are more likely to develop skin itching and scarring in children.
作者
马坪楠
邓永上
温文星
熊胜文
周卓
罗伟东
XIONG Sheng-wen;ZHOU Zhuo;LUO Wei-dong(Department of Hand and Foot Surgery,the Third People′s Hospital of Huizhou,Guangdong Province,Huizhou 516001,China)
出处
《河北医科大学学报》
CAS
2018年第11期1279-1282,1286,共5页
Journal of Hebei Medical University
基金
惠州市科技计划项目(2017Y144)
关键词
软组织损伤
外科皮瓣
修复外科手术
soft tissue injuries
surgical flaps
reconstructive surgical procedures
