跟踺延长术修复烧伤后足下垂28例

The experiences in correction of cicatricial foot drop in 28 patients

目的 总结近年来收治的 2 8例 37只烧伤足下垂的体会。方法 比较不同手术设计、烧伤早期创面不同处理方式及伤后至手术的时间长短对瘢痕跟踺瓣存活的影响。结果 跟踺延长术常规手术设计与逆常规方向设计比较 ,两组瘢痕跟踺瓣的存活无差别 ;早期切痂者较削痂和自愈者术后瘢痕跟踺瓣坏死率高 ;伤后 1.5年内手术者较 1.5年后手术者更易出现瘢痕跟踺瓣的坏死。结论 跟踺延长术瘢痕跟踺瓣的设计无需拘泥于以往制定的规则 ;对早期切痂者手术应慎重考虑 ;

Objective To summarize the experiences in correction of cicatricial foot drop. Methods 37 cicatricial drop feet in 28 postburn patients were treated in recent 4 years. The cicatricial flap survival rate was documented to compare the effects of two surgical designs, the different intervals from burn to the operation and three surgical methods used in early burn stage. Results All of the 37 wounded feet got satisfactory correction. There was no significant statistic difference in flap survival between the two surgical designs. More necrosis of the flap was observed in patients who received early escharectomy (including full thickness skin and fat) or had been burned for less than 1^5 years. Conclusions The reverse design of the Achilles tendon flap for correction of drop foot was as safe and effective as a routine design. The operation method used in early burn stage and the interval from burn to the corrective operation should be considered in cicatricial flap design.