修薄的背阔肌肌瓣联合植皮修复足背大面积软组织缺损

Reconstruction of soft tissue defect of the foot dorsum with trimmed latissimns dorsi free muscle flapwith skin grafting

目的探讨修薄的背阔肌肌瓣游离移植联合游离植皮修复足背大面积软组织缺损的应用和治疗效果。方法自2005年6月至2011年10月，共收治11例足背皮肤软组织缺损的患者，年龄4-46岁，其中男8例，女3例；早期创伤7例，贴骨瘢痕及陈旧性损伤4例。清创后缺损面积5．0cm×6．0cm-8．0cm×12．0cm，均伴有不同程度的肌腱、骨质外露。11例患者均采用修薄的背阔肌肌瓣游离移植联合游离植皮的方法修复创面。结果术后肌瓣及移植皮片均成活良好．7例术后随访3-10个月，外形良好，可正常穿鞋，移植皮片质地柔软，稍有色素沉着。结论选用修薄的肌瓣游离移植表面植皮修复后组织的质地较薄，避免了皮瓣和肌皮瓣移植后臃肿的缺点，是修复足背缺损的较好方法。

Objective To discuss the clinical application of using trimmed latissimus dorsi free mus- cle flap together with skin grafting to resurface soft tissue defects on the dorsum of the foot. Methods From June 2005 to October 2011, eleven patients （8 males and 3 females, aged from 4-46 years） with large soft tissue defects of the foot dorsum were treated in our department. The size of the defects after debridement ranged from 5.0 cm× 6.0 cm-8.0 cm× 12.0 cm, all with exposed tendons or bones. Trimmed free latissimus dorsi muscular flap with split thickness skin grafting was used for reconstruction for all the 11 patients. Re- suits All the flaps survived with no complications after surgery. During 3-10 months＇ follow-up, the appear- ance and walking function were satisfying, no further debulking procedures were needed. Conclusion Trimmed latissimus dorsi free flap with skin grafting is a good option for dorsal defect reconstruction.