局部角形穿支皮瓣的临床应用

Clinical application of the local plantar horn-shaped perforator-flaps

目的：探讨局部角形穿支皮瓣在修复全身各处软组织缺损中的临床疗效。方法本组共26例患者。缺损面积为1.0cm×2.0cm-13.0cm×13.0cm,根据缺损面积形状在其邻近周围用多普勒血流探测仪探测穿支血管,设计不同大小的角形穿支皮瓣带蒂转移,Ⅰ期修复缺损,供区直接缝合。结果26例皮瓣均成活。10例面部切口均Ⅰ期成活,1例躯干供瓣区少许切口裂开,2例四肢皮瓣远端淤血,表皮剥脱均经短期内换药后愈合。结论局部角形穿支皮瓣带蒂转移可灵活应用于全身各处软组织缺损的修复。皮瓣设计成角形易于旋转和推进,穿支血管可确保皮瓣的成活率,在修复局部软组织缺损中有着良好的应用前景。

Objective To investigate the clinical effects of the plantar horn-shaped perforator flaps on repair of the soft tissues defects.Methods A total of 26 patients with soft tissue defects in the trunk and the extremities were treated with the local plantar horn- shaped perforator- flaps in which caused by tumor,pressure,sores,trauma.For 1.0 cm×2.0 cm to 13.0 cm× 13.0 cm soft tissue defects,flaps were selected based solely on preoperative Doppler mapping in areas adjacent to soft-tissue defects.Re-sults All the flaps survived completely without any complications except one with slight disruption in the trunk and 2 cases with congestion and exfoliation in the distal end of flap which were healed after dress-ing.Conclusion The local plantar horn-shaped perforator flaps can be used for repairing soft tissue de-fects throughout the entire body.The plantar horn-shaped still allowed sufficient movement either as a rotation or advancement flap or as a combination of both,also have good application value and clinical effect in repairing soft tissue defects.