封闭式负压引流结合腓肠神经营养血管皮瓣修复足踝部皮肤缺损的临床观察

Clinical Observation of Repair of Skin Defect on Ankle under Enclosed Negative Drainage Joint Sural Nerve Nutrient Vascular Flap

目的总结封闭式负压引流(VSD)联合腓肠神经营养血管皮瓣修复足踝部皮肤缺损的临床疗效。方法 2008-09～2012-08间共治疗了18例足踝部及足跟腱部软组织缺损患者,男12例,女6例;年龄7～61岁,平均年龄为41岁。皮肤缺损面积为5.0 cm×4.0 cm～13.5 cm×11.0 cm。首先采取清创术和VSD,待创面情况良好后,应用腓肠神经营养血管逆行蒂岛状皮瓣,切取面积为6.0 cm×5.0 cm～15.0 cm×12.0 cm,修复足踝部创面。结果 15例全部成活,术后2例皮瓣边缘感染,1例出现瘀肿的静脉危象,经处理后愈合。皮瓣质地良好,外观尚可。结论 VSD结合腓肠神经皮瓣适合应用于损伤和感染严重的创面。

Objective To investigate clinical effect of the repair of the skin defect under enclosed negative pressure drainage vacuum sealing drainage,joint sural nerve nutrient vessels of the ankle skin flap.Methods In September 2008 to August 2012,a total of 16 cases of ankle treatment of soft tissue defect patients,(9 male cases and 7 female cases),and 7~61 years old,with an average age of 41 years old,is treated.Skin defect area is 5.0 cm×4.0 cm^13 cm×11.0 cm.After a phase line debridement and VSD,and wound clean,the sural nerve nutrient vessels′s retrograde island flap is used.Chipped area of repair ankle department wound is 6.0 cm×5.0 cm^15.0 cm×12.0 cm.Results 15 cases were all survived,postoperative 2 cases were suffered with distal skin flap necrosis,l cases venous crisis,the processed healing.Flap is in its good quality,and appearance is ideal.Conclusion VSD can provide good for skin flap to repair tissue bed.