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负压封闭引流联合股前外侧穿支皮瓣修复足部软组织缺损
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作者Author单位UnitE-Mail
欧昌良 OU Chang-liang 西南医科大学附属第二医院骨伤手外科, 四川 泸州 646000 Department of Orthopaedic Hand Surgery, the Second Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China  
邹永根 ZOU Yong-gen 西南医科大学附属第二医院骨伤手外科, 四川 泸州 646000 Department of Orthopaedic Hand Surgery, the Second Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China  
罗成 LUO Cheng 西南医科大学附属第二医院骨伤手外科, 四川 泸州 646000 Department of Orthopaedic Hand Surgery, the Second Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China 452036229@qq.com 
周鑫 ZHOU Xing 西南医科大学附属第二医院骨伤手外科, 四川 泸州 646000 Department of Orthopaedic Hand Surgery, the Second Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China  
罗旭超 LUO Xu-chao 西南医科大学附属第二医院骨伤手外科, 四川 泸州 646000 Department of Orthopaedic Hand Surgery, the Second Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China  
期刊信息:《中国骨伤》2018年31卷,第7期,第666-670页
DOI:10.3969/j.issn.1003-0034.2018.07.015


目的:探讨负压封闭引流联合股前外侧穿支皮瓣修复足部软组织缺损的临床效果。

方法:自2014年9月至2016年9月,采用负压封闭引流联合股前外侧穿支皮瓣修复足部软组织缺损患者45例,其中男31例,女14例,年龄17~55岁,平均36岁。足背软组织缺损30例,足底软组织缺损15例。面积7 cm×10 cm~11 cm×18 cm,创面重度污染,均伴深层软组织外露。在急诊下行创面清创加负压封闭引流处理,5~7 d创面清洁后,予以游离股前外侧皮瓣修复,皮瓣切取面积为9 cm×12 cm~13 cm×21 cm,选择合适的方法修复皮瓣供区。

结果:术后45例皮瓣全部愈合,无皮肤边缘坏死,无破溃感染。40例患者获得随访,时间3~24个月,平均13个月。皮瓣色泽良好,外形美观,弹性较好,质地柔软,无明显臃肿,供区愈合良好。

结论:应用负压封闭引流联合股前外侧穿支皮瓣修复足部软组织缺损,可以有效控制创面软组织感染,切取皮瓣血供可靠,皮瓣可Ⅰ期修复,是修复足部软组织缺损的有效方法。
[关键词]:负压封闭技术  修复外科手术  穿支皮瓣  软组织损伤
 
Vacuum sealing drainage with anterolateral thigh perforator flap for repair foot soft tissue defect
Abstract:

Objective: To investigate clinical effect of vacuum sealing drainage(VSD) with anterolateral thigh perforator flap for repair foot soft tissue defect.

Methods: From September 2014 to September 2016,45 patients with foot soft tissue defect repaired by VSD with anterolateral thigh perforator flap,including 31 males and 14 females aged from 17 to 55 years with an average of 36 years old. Thirty patients were dorsal soft tissue defects,and 15 patients were plantar soft tissue defects. Sizes of soft tissue defect ranged from 7 cm×10 cm to 11 cm×18 cm,the wound was contaminated seriously and assisted with deep soft tissue exposure. Emergency surgical wound debridement with VSD treatment were performed,and wound surface was cleaned after 5 to 7 days,free anterolateral thigh flap were repaired. Sizes of flap ranged from 9 cm×12 cm to 13 cm×21 cm. Appropriate method was used to repair flap donor area.

Results: All 45 free propeller flap were survived without skin edge necrosis,ulcerative infection. Forty patients were followed up from 3 to 24 months with an average of 13 months. Flap showed good color,beautiful appearance,good elasticity,soft texture,but without obvious bloated,the wood of leg healed well.

Conclusion: VSD with anterolateral thigh perforator flap for repair foot soft tissue defect could effective control wound soft tissue infection,receive reliable flap blood supply and skin flap could repaired at stageⅠ. It is an effective method for repairing foot soft tissue defects.
KEYWORDS:Vaccum-assisted closure  Reconstructive surgical procedures  Perforator flap  Soft tissue injuries
 
引用本文,请按以下格式著录参考文献:
中文格式:欧昌良,邹永根,罗成,周鑫,罗旭超.负压封闭引流联合股前外侧穿支皮瓣修复足部软组织缺损[J].中国骨伤,2018,31(7):666~670
英文格式:OU Chang-liang,ZOU Yong-gen,LUO Cheng,ZHOU Xing,LUO Xu-chao.Vacuum sealing drainage with anterolateral thigh perforator flap for repair foot soft tissue defect[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(7):666~670
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