游离髂腹股沟皮瓣在足部创面的应用

Clinical application of free groin flap in treating wound surface of foot

目的探讨游离髂腹股沟皮瓣修复足外伤软组织缺损的临床效果。方法应用游离髂腹股沟皮瓣修复足外伤软组织缺损12例，缺损面积：6cm×13cm-10cm×20cm，平均8cm×16cm，其中软组织感染5例。入院清创、骨折内固定，感染病例先行负压封闭引流（VSD）治疗1周，待感染控制后切取皮瓣修复创面。结果12例皮瓣全部成活．创面一期愈合，随访3个月～1年，疗效满意，皮瓣质地柔软，外观臃肿不明显，供区愈合良好，仅留有线状瘢痕。根据下肢负重是否疼痛、关节活动度及恢复工作等指标评价下肢肢体功能．优良率为85％。结论足外伤软组织缺损行游离腹股沟皮瓣修复可获得较满意疗效。

Objective To explore the clinical application of free groin flap for repairing soft tissue defect in the wound surface of feet. Methods 12 cases with soft tissue defect of feet were repaired with free groin flap from January 2007 to December 2010. The defect area ranged from 6cm×13cm to 10cm×20cm, average area 8.0cm×16.0cm, and 5 cases occured soft tissue infection. Debridement and internal fixation of fractures were performed after admission.Vacuum Sealing Drainage （VSD） were applied about 1 week in the cases of infection, and then wound surface were repaired with flee flaps when the infection was controlled. Results 12 cases completely survived, of those 12 cases with primary healing. Followed up from 3 to 12 months, obtained satisfactory therapeutic effect （the rate of excellence and good was 85%）, evaluation of lower extremity function by the pain after weight loading, motion range of joint and return to work. The texture of flap were soft, shape of swollen were not obviously, and the donor area healed fine, only remained linar scar. Conclusion It can obtain satisfactory therapeutic effect for using free groin flap to treat feet soft tissue defect.