摘要
目的回顾分析小腿及足部软组织缺损、骨及肌腱外露采用不同类型的皮瓣移植修复后的远期疗效。方法采用７种不同类型的皮瓣对小腿及足部软组织缺损进行修复６６例，其中吻合血管的皮瓣移植２８例，带蒂皮瓣３６例，交腿皮瓣２例。皮瓣面积最大３０ ｃｍ×１５ｃｍ，最小６ｃｍ×４ｃｍ。其中吻合血管的皮瓣修复足底负重区皮肤缺损５例。结果吻合血管的皮瓣移植组中有２例坏死，３例部分坏死，其余皮瓣均成活，随访２～５年，吻合血管的不带感觉神经的皮瓣移植修复足底负重区者，３例出现了反复发作的溃疡，腹部皮瓣或肌皮瓣移植于足部后过于臃肿，影响负重功能。修复小腿组织缺损者，效果及外观均满意。结论小腿及足部的慢性溃疡，较长时间的感染对血管造成损害，通常局部粘连较重，血管解剖游离困难，血管功能障碍，致使术后血管危象发生率高。因此，此类损伤宜采用带蒂皮瓣进行修复。足底负重区的软组织缺损，以足底内侧皮瓣修复效果最佳，如果用吻合血管的皮瓣移植最好用带感觉神经的皮瓣修复，以满足皮瓣对足部负重的要求。
Objective To retrospect and analysis the long-term follow-up results of different kinds of flaps in repairment of the defects in legs and feet' Methods Seven different kinds of flaps or musculocutaneous flaps were used to repair for 66 cases of the soft tissue defect in legs and feet;of the areas from 30 cm × 15 cm to 6 cm× 4 cm, 28 flaps were transplanted with vessel anastomosis;36 flaps were pedicle and 2 flaps were crossed legs. Results Two flaps with vessel anastomosis were necrosis,three were necrosis partly' Others were healed by first intention. 5 cases of the flaps in foot weight carrying areas were ulceration at different times after operation, 1 case was intraltable ulcer. conclusion The chronic ulceration and infection cause the leg and foot vessel injury,local tissue adhesion and dissection difficultly. all these causes result in blood vessel crisis after operation. It's better to use pedical flap to repair this kind injury. The result is good to use medial flap of foot to rapair the soft tissue defect of heavy load region of foot. If using flap of anastomotic vessel to trasplant, it's much better to use flap containing sensative nerve to repair the defect so that it can satisfy the demand of foot heavy load
出处
《中华显微外科杂志》
CSCD
北大核心
2000年第3期182-184,共3页
Chinese Journal of Microsurgery
