前足部皮肤软组织缺损的皮瓣修复

Repair of soft tissue defect in front foot skin by the application of skin flap

目的:总结不同类型皮瓣修复前足部皮肤软组织缺损的疗效。方法:2003年9月至2009年9月,应用各种皮瓣修复前足软组织缺损32例,其中包括带蒂的逆行小腿内侧皮瓣3例、足底内侧逆行岛状皮瓣2例、远端蒂足内侧皮瓣2例、踝前皮瓣4例、第一跖背动脉皮瓣7例、对侧内踝上皮支皮瓣2例、游离股前外侧皮瓣9例、游离背阔肌皮瓣3例。结果:32例皮瓣均成活,术后随访5～15个月,皮瓣质地好,外形美观,大部分恢复保护性感觉;均保持了跖趾关节功能,能负重行走,足功能满意;供区植皮耐磨,无破溃。结论:前足部皮肤软组织缺损的修复,可根据皮肤缺损的部位及创面大小,正确选择不同类型的外科皮瓣;而防止和处理血管危象的发生是取得良好疗效的关键。

Objective：To summarize and report the therapeutic effect by applying different types of flaps to repair the soft tissue defect in front foot.Methods：During the period from September of 2003 to September of 2009,flaps had been applied to repair the soft issue detect in front foot,including 20 cases pedicled flaps and 12 cases free flaps.Results：All 32 cases flaps survived after surgeries.Most of the flaps restored the function of protective sensation with good quality and appearance after 5-15 months of follow up.All of them preserved the function of metatarsus toe jointed and could sustain the burdened of walking with satisfying foot function.Conclusions：Different types of surgical flaps can be used to repair the defect of font foot depending on the location of the defect and the size of the wound.Choosing accurate flaps,preventing and managing vascular crisis is the key for optimal therapeutic effectiveness.