摘要
目的基于胫后动脉内踝上穿支皮瓣和腓动脉穿支皮瓣修复四肢皮肤软组织缺损的手术方法和临床效果,探讨小腿穿支皮瓣修复四肢皮肤软组织缺损的临床疗效。方法对2011年5月-2018年5月收治的109例四肢皮肤软组织缺损患者的治疗方法进行回顾性研究,其中应用小腿穿支皮瓣修复的61例设为观察组,以小腿内侧皮瓣修复的48例设为对照组。术后随访3~6个月,观察移植皮瓣成活情况、皮瓣供区植皮成活情况;肌腱粘连、肢体肿胀、骨不连及血管危象等并发症发生率;术后两组的运动功能、日常生活能力、感觉及血液循环等恢复情况。结果观察组和对照组的移植皮瓣成活率分别为85.24%和85.41%(P>0.05);供区皮肤的愈合率分别为93.44%和93.75%(P>0.05);血管危象的发生率分别是13.11%和13.33%(P>0.05);术后功能评分优良率分别为85.24%和91.67%(P>0.05)。结论小腿穿支皮瓣不仅与小腿内侧皮瓣成活率和供区皮肤的愈合率差异无统计学意义;同时动脉危象和静脉危象等近期并发症和感染、骨不愈和、肌腱粘连、指腹萎缩、畸形等远期并发症的发生率差异也无统计学意义;而且避免损失下肢主要动脉。因此小腿穿支皮瓣修复四肢皮肤软组织缺损的术式值得临床推广应用。
Objective To investigate the clinical effect of the lower leg perforator flaps to repair skin soft tissue.Methods The clinical data of 109 patients with skin and soft tissue defects of extremities from May 2011 to May 2018 were retrospectively studied.61 cases which repaired with perforator flaps of the lower leg were experimental group,and 48 cases which repaired were medial leg flaps were control group.Postoperative following-up included to observe the survival of transplanted skin flaps,skin grafting in donor site,tendon adhesion,limb swelling,bone nonunion and vascular crisis.The recovery of motor function,daily living ability,sensation and blood circulation in each group 2 years after operation were observed.Results The survival rate of transplanted skin flaps in experimental group and control group was respectively 85.24%and 85.41%(P>0.05);the healing rate of donor skin was 93.44%and 93.75%(P>0.05);the occurrence rate of vascular crisis was 13.11%and 13.33%(P>0.05);and the excellent and good rate of functional score was 85.24%and 91.67%(P>0.05).Conclusion There is no significant difference between the survival rate of perforator flaps and medial leg flaps,the healing rate of donor skin,short and long-term complications.Therefore,the method of repairing the skin defect of extremities with perforator flaps of the leg was worth popularizing.
作者
王瑛
WANG Ying(Department of Orthopedics,The People's Hospital of Zhucheng City,Zhucheng,Shandong,262200,China)
出处
《实用手外科杂志》
2019年第3期302-305,共4页
Journal of Practical Hand Surgery
关键词
穿支皮瓣
修复
皮肤缺损
Perforator flap
Repair
Skin defect
