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闭式负压引流联合带腓肠神经营养血管皮瓣修复近踝足部肌腱与骨外露创面
Hits: 3024   Download times: 1286   Received:March 20, 2010    
作者Author单位UnitE-Mail
刘华水 LIU Hua-shui 济南市第三人民医院, 山东 济南 250101 The Third People's Hospital of Jinan,Jinan 250101,Shandong,China jnsylhs2008@163.com 
楚万忠 CHU Wan-zhong 济南市第三人民医院, 山东 济南 250101 The Third People's Hospital of Jinan,Jinan 250101,Shandong,China  
栾涛 LUAN Tao 济南烟草职工医院  
谢新敏 XIE Xin-min 济南市第三人民医院, 山东 济南 250101 The Third People's Hospital of Jinan,Jinan 250101,Shandong,China  
李强 LI Qiang 济南市第三人民医院, 山东 济南 250101 The Third People's Hospital of Jinan,Jinan 250101,Shandong,China  
布金鹏 BU Jin-peng 济南市第三人民医院, 山东 济南 250101 The Third People's Hospital of Jinan,Jinan 250101,Shandong,China  
李来峰 LI Lai-feng 济南市第三人民医院, 山东 济南 250101 The Third People's Hospital of Jinan,Jinan 250101,Shandong,China  
赵学春 ZHAO Xue-chun 济南市第三人民医院, 山东 济南 250101 The Third People's Hospital of Jinan,Jinan 250101,Shandong,China  
刘晓萌 LIU Xiao-meng 济南市第三人民医院, 山东 济南 250101 The Third People's Hospital of Jinan,Jinan 250101,Shandong,China  
期刊信息:《中国骨伤》2010年23卷,第8期,第613-615页
DOI:10.3969/j.issn.1003-0034.2010.08.018


目的:评价用闭式负压引流(VSD)技术联合带腓肠神经营养血管皮瓣修复近踝足部肌腱与骨外露创面的实用方法。

方法:2006年1月至2009年1月应用VSD技术联合带腓肠神经营养血管皮瓣修复治疗79例近踝足部肌腱与骨外露创面患者,男58例,女21例;年龄7~59岁,平均34岁。其中小腿下1/3及跟腱区17例,外踝及足背外侧区28例,内踝及足内侧区21例,足跟及足底13例。创面Ⅰ期用VSD技术清创培养,Ⅱ期用带腓肠神经营养血管皮瓣修复。

结果:皮瓣面积最大18 cm×15 cm,最小6 cm×5 cm.住院时间14~30 d,平均18 d.79例患者随访6~36个月,2例皮瓣大部分坏死,3例皮瓣皮缘坏死,5例皮瓣术后出现静脉回流障碍,其余皮瓣均成活良好,无感染。

结论:通过VSD技术可尽快形成一个肉芽组织新鲜清洁的创面;带腓肠神经营养血管皮瓣能为近踝足部肌腱与骨外露创面提供良好的覆盖。二者联合应用创面愈合快,修复后外形好,耐磨擦,大大缩短了患者住院时间。
[关键词]:    软组织损伤  引流术  外科皮瓣  修复外科手术
 
Analysis of the vacuum sealing drainage technique combined with sural neurovasculr pedicle fascio-cutaneous flap to repair deep wounds in the foot near the ankle joint with exposed bone and tendons
Abstract:

Objective: To evaluate the practical method of vacuum sealing drainage (VSD) technique combined with sural neurovasculr pedicle fasciocutaneous flap to repair deep wounds in the foot near the ankle joint with exposed bone and tendons.

Methods: From January 2006 to January 2009,79 patients with deep wounds in the foot near the ankle joint with exposed bone and tendons were treated by VSD technique combined with sural neurovasculr pedicle fasciocutaneous flap including 58 males and 21 females with an average age of 34 years old ranging from 7 to 59 years. There were 17 cases in low 1/3 part of leg and achilles tendon,28 in lateral malleolus and lateral dorsum of foot,21 in medial malleolus and medial dorsum of foot,13 in heel and pelma. Firstly the wounds were debrided and cultivated by using VSD technique,then the soft tissue defections were repaired with sural neurovasculr pedicle fasciocutaneous flap.

Results: The area of flap was from 6 cm×5 cm to 18 cm × 15 cm; All patients stayed in hospital for 14 to 30 days,18 days in average. Living flaps of all patients were followed-up from 6 months to 3 years,the flaps of 2 patients were mostly necrotic,3 were necrotic,5 cases appeared obstacle of venous back streaming. The others survived with no infections.

Conclusion: The wound would become fresh and clean as soon as possible with VSD. The sural neurovasculr pedicle fasciocutaneous flap could provide a good covering for the exposed wound. Therefore the wound healed faster with friction resistance and fine appearance. The time of hospitalization were greatly shortened after combined application.
KEYWORDS:Foot  Ankle  Soft tissue injuries  Drainage  Surgical flaps  Reconstructive surgical procedures
 
引用本文,请按以下格式著录参考文献:
中文格式:刘华水,楚万忠,栾涛,谢新敏,李强,布金鹏,李来峰,赵学春,刘晓萌.闭式负压引流联合带腓肠神经营养血管皮瓣修复近踝足部肌腱与骨外露创面[J].中国骨伤,2010,23(8):613~615
英文格式:LIU Hua-shui,CHU Wan-zhong,LUAN Tao,XIE Xin-min,LI Qiang,BU Jin-peng,LI Lai-feng,ZHAO Xue-chun,LIU Xiao-meng.Analysis of the vacuum sealing drainage technique combined with sural neurovasculr pedicle fascio-cutaneous flap to repair deep wounds in the foot near the ankle joint with exposed bone and tendons[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(8):613~615
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