股前外侧薄皮瓣修复糖尿病足溃疡9例

Reconstruction of the diabetic foot using the anterolateral thigh thin flap:a 9 cases report

目的探讨外科治疗糖尿病足溃疡以降低致残率的措施,采用股前外侧薄皮瓣修复糖尿病足溃疡。方法自2004年8月至2007年3月,在内科综合治疗,一般状况控制良好的基础上采用股前外侧薄皮瓣修复糖尿病足溃疡9例。结果9例患者中,8例获得成功,皮瓣质地良好,与周围皮肤感觉无明显差异,恢复后均可负重行走,术后平均随访10个月无溃疡复发。结论股前外侧薄皮瓣修复糖尿病足溃疡是一种安全、有效的治疗方法。

Objective To evaluate the outcome of the diabetic foot reconstructed with the anterolateral thigh thin flap and reduce its high amputation rate, Methods This study reviews 9 cases of salvaged diabetic foot over a 30 - month period. Patients ranged in age from 45 to 68 years （ average ,54 years） ,with an average follow - up of 10 months. Results Flaps survived in all but one reconstructed case, resuhing in equivocal findings compared with microvascular free tissue transfer of nondiabetic patients, During the follow -up, 8 patients achieved full weight bearing, acceptable contour, and quality of gait. However, late complications such as recurrence of ulceration was noted in one patient, who was blind and unable to perform daily inspection of the foot. Conclusions The anterolateral thigh thin flap provides well -vascularized tissue that controls infection, a thin flap that provides one - stage contouring and minimizes shearing, and a skin paddle that resists pressure and improves durability. The flap can also be combined with vastus lateralis muscle to increase bulk and blood supply against large dead spaces and chronic infections, Anterolateral thigh thin flaps can be used to achieve acceptable function and aesthetic results for diabetic foot reconstruction.