封闭负压引流联合腓肠肌肌皮瓣治疗胫前软组织缺损

Vacuum sealing drainage with gastrocnemius muscle flap in the treatment of soft tissue defects of the anterior tibia

目的探讨封闭负压引流(VSD)联合腓肠肌肌皮瓣治疗胫前软组织缺损的效果。方法对16例胫前中上2/3软组织缺损患者应用VSD联合腓肠肌肌皮瓣治疗。结果 16例均获随访,时间3个月～3年。1例患者行岛状肌皮瓣转移时,因皮瓣血运差改行肌瓣转移+植皮术,全部成活;1例患者出现内固定物排异反应,去除内固定物后伤口愈合。余14例患者皮瓣均成活,伤口一期愈合,对患肢膝、踝关节功能无明显影响。结论一期应用VSD覆盖创面,后行腓肠肌肌皮瓣转移治疗胫前不同平面软组织缺损,操作简单,效果满意。

Objective To explore the effect of vacuum sealing drainage （VSD） and gastrocnemius muscle flap in the treatment of soft tissue defects of the anterior tibia. Methods 16 cases with soft tissue defects of the anterior tibia in the upper 2/3 were treated with VSD and gastrocnemius muscle flap. Results 16 cases were followed up from 3 months to 3 years. 1 patient underwent myocutaneous flap, the flap blood supply to be diverted to the muscle flap transfer plus skin grafting, skin grafts survived ; one case of internal fixation of rejection, wound healing after the removal of internal fixation. 14 flaps survived with primary wound healing. The knee and ankle function got no significant affected. Conclusions With VSD covering wounds, different plane of gastrocnemius myocutaneous flap in treatment of anterior tibial soft tissue defect, the operation is simple, and provides satisfactory effect.