外踝上瘢痕穿支皮瓣在软组织缺损修复应用中的分析

Analysis on Application of Lateral Malleolus Perforator Flap with Scar in Soft Tissue Reconstruction

目的探讨外踝上瘢痕穿支皮瓣在软组织缺损修复应用中的意义。方法对12例外踝及外踝上下软组织缺损伴深部组织外露创面应用外踝上穿支皮瓣修复创面。其中6例患者小腿外侧中下部有过皮肤烧伤或外伤创面非手术治疗愈合病史,该区有明显较平瘢痕。结果12例手术均顺利,术中顺利分离血管和皮瓣旋转修复创面,但6例小腿外侧中下部有瘢痕病例第2日开始出现皮瓣淤血,及时行皮瓣切开,改善微循环,但只有2例皮瓣淤血改善最终存活,4例皮瓣未存活,改使用其他方法修复创面。结论应用瘢痕穿支皮瓣修复创面存活率不高,应相当谨慎。

[ Objective] To analysis the application value of lateral malleolus perforator flap with scar in soft tissue reconstruction. [ Methods] The wound surface of 12 cases with soft tissue defected and bone leaked out on lateral malleolus were repaired by the lat- eral malleolus perforator flap. Among them, 6 cases had obvious fiat scar in lower-middle part of lateral, leg, which induced by skin burn or wound healing with non-operation treatment. [ Results] All the operations were successful, blood vessels were divided successfully from the soft tissue and the wound surface was covered by perforator flap. But the skin flap of 6 cases with scar in lowermiddle part of lateral leg appeared congestion on the second day. After cutting the flap to improve microcirculation immediately, only 2 cases skin flap were survived. The wound surfaces of other 4 cases were repaired by the other methods. [ Conclusion] The survival rate of wound surfaces repaired by perforator flap with scar was low, so the application should be careful.