移植修复术在肌腱损伤伴足背复合组织缺损治疗中的应用

The application of transplantation repair of tendon injury with dorsalis pedis composite tissue defect

目的探讨移植修复术在肌腱损伤伴足背复合组织缺损治疗中的应用价值。方法选取2010年1月至2012年1月期间肌腱损伤伴足背复合组织缺损患者共39例,全部患者行清创术处理,经创面彻底清创后应用持续性负压引流技术完全覆盖创面,清创术后1周行旋股外侧动脉降支皮瓣移植术,移植术后8~12周实施皮瓣修复术,观察患者创面、伤口愈合和足部功能恢复状况。结果 39例移植修复术患者,皮瓣成活率100.00%（39/39）,创面Ⅰ期愈合,切口Ⅰ期愈合,术后随访发现,皮瓣外形满意,质地柔软,厚度和弹性均适宜,具有排汗、足部背伸和屈曲功能,且无足趾部并发症的发生,术后36个月创面愈合后瘢痕指数明显改善,优于术后6、12个月,差异具有统计学意义（P〈0.05）。结论旋股外侧动脉降支皮瓣移植修复术有助于促进肌腱损伤伴足背复合缺损组织愈合,不影响足背功能,无明显并发症。

Objective To investigate the application of transplantation repair of tendon injury with dorsalis pedis composite tissue defect.Methods 39 patients with tendon injury combined dorsalis pedis composite tissue were selected in our hospital during January 2010 to January2012. All patients underwent debridement treatment after full disinfection cleaning wound. The application of continuous negative pressure drainage completely cover the wound debridement after 1 weeks. These patients were given lateral circumflex femoral artery descending branch flap grafting,skin flap repair of the implementation of 8 ~ 12 weeks after transplantation. The patient wound,wound healing and the functional recovery of the foot were observed. Results 39 cases received repair of transplant patients,with 100% flap survival rate（ 39 /39）. The wound healed after surgery. During follow-up,flap,soft texture,thickness and elasticity are suitable with sweat,foot dorsal extension and flexion function. No foot toe complications were reported 6 after 12 months. The scar index improved significantly better than the 36 months after operation,wound healing after surgery,with significant difference（ P 0. 05）. Conclusion Lateral circumflex femoral artery descending branch flap transplantation repair help promoting tendon injury with dorsalis pedis composite tissue defect healing. This method does not affect dorsal foot function,and no obvious complication.