足跟部皮肤软组织缺损的修复

Repairing of skin and soft-tissue defects of heel

目的报道足跟部皮肤软组织缺损修复的方法和体会。方法 2006年1月~2010年8月,应用两种皮瓣转移方法修复足跟组织缺损16例,男11例,女5例;年龄6~52岁,平均26.8岁;左侧6例,右侧10例。皮肤软组织缺损范围大小13 cm×6.0 cm^5.0 cm×4.5 cm,13例伴有跟骨外露,7例伴有跟腱外露。皮瓣选择:腓肠神经营养血管蒂小腿逆行皮瓣11例,足底内侧皮瓣5例。皮瓣大小16 cm×7.5 cm^6.0 cm×5.5 cm。结果除1例腓肠神经营养血管蒂皮瓣远端部分坏死补充植皮外,本组15例患者皮瓣全部成活,随访6个月~3年,足跟部及跟腱组织缺损获得满意修复,皮瓣质地及外形良好,局部功能恢复满意。结论腓肠神经营养血管蒂小腿逆行皮瓣是修复伴有跟腱外露的足跟缺损的较好方法,足底内侧皮瓣则适用于面积较小的足跟缺损。

【Objective】To report the method to repair defects of heel.【Methods】From January 2006 to August 2010,2 kinds of flap were used for reconstruction of defects of heel in 16 cases.They were 11 males and 5 females and their ages ranged from 6 to 52 years old with an average of 26.8 years.Among 16 cases,6 cases had defects in the left heel and 10 in the right.The size of the defects were 13 cm×6.0 cm～5.0 cm×4.5 cm and calcaneus exposed in 13 cases and Achilles tendon exposed in 7 cases.Eleven were repaired with the reverse sural flaps and 5 with the medial plantar flaps.The size of the flaps were 16 cm×7.5 cm～6.0 cm×5.5 cm.【Results】All the flaps survived except partial necrosis in one sural flap.Follow-ups of 6 months to 3 years showed all the flaps had a good appearance and the function was excellent.【Conclusion】The reverse sural flap was an effective method to repair the defect of heel companied by heel and Achilles tendon exposed,and the medial plantar flap was beneficial to the smaller defect of heel.