外踝上皮瓣修复足部软组织缺损20例及失败病例分析

Lateral supramalleolar skin flap for reconstruction of soft tissue loss on foot and worse-cases analysis

目的探讨外踝上逆行岛状皮瓣修复足部远端软组织缺损的效果,分析失败病例原因和预防措施。方法应用腓动脉终末穿支的降支为血管蒂,行外踝上逆行岛状皮瓣修复前足和足外侧软组织缺损20例。结果 18例皮瓣成活,皮瓣质地优良,随访6-12个月,外观及功能满意。2例出现部分坏死,延误治疗。结论外踝上逆行岛状皮瓣是修复足部软组织缺损的良好皮瓣。该皮瓣切取方便,血供丰富,不损伤肢体主要血管。但病例选择不当,就会延误治疗,造成严重后果。

Objective To investigate the reconstructive effect of lateral suprainallcolar reversed island skin flap in soft tissue injury on foot and analyse worse-cases.Methods Twenty patients with soft tissue injury on foot were treated with lateral supramallcolar reversed island skin flap.Results The skin flap survived in eighteen patients.The color and texture of the skin flap were nearly normal.Their appearance and function were satisfactory after six to twelve months follow-up.The flaps of two cases presented partial necrosis,and delayed treatment was done.Conclusion Lateral supramallcolar reversed island skin flap is a favourable skin flap for the reconstruction of soft tissue injury on foot.The dissection is easy to be done.The flap has a rich blood supply without injury of major blood-vessels.Proper application is needed in order to avoid harmful consequences.