小腿逆行穿支皮瓣修复足踝部创面的临床思路探索和构建

Clinical Thinking Exploration and Construction for Repairing Foot and Ankle Wounds with Retrograde Calf Perforator Flap

目的通过分析足踝部创面情况探索并构建小腿逆行穿支皮瓣修复术临床思路,评估其临床疗效。方法选取自2011年6月至2014年6月由于各种原因导致的足踝部创面患者58例,分别采用逆行腓动脉穿支皮瓣、胫后动脉穿支皮瓣以及腓肠神经营养血管皮瓣进行修复。结果术后创面恢复良好,其中4例皮瓣部分坏死,经换药后创面愈合,1例皮瓣完全坏死经游离植皮后创面愈合较好。相较治疗前,治疗后疼痛程度明显减轻,日常生活能力明显提高(P<0.05)。结论小腿逆行穿支皮瓣对于修复足踝部创面具有显著的临床疗效,手术操作简单,较安全,且保证了患者的生活质量,值得在临床中推广。

Objective To explore and construct the clinical thinking of retrograde calf perforator flap by analyzing the foot and ankle wounds situation, and assess the clinical efficacy. Methods From June 2011 to June 2014 58 patients with foot and ankle wounds were respectively treated with retrograde peroneal artery perforator flap, posterior tibial artery perforator flap and retrograde island skin flap with sural vessels. Results All wounds healed well, including four cases of flap partially necrosised which healed after dressing. One case of flap completely necrosised which healed by skin graft. Compared with before treatment, the pain degree decreased obviously after the treatment,daily life ability improved significantly（P〈0.05）. Conclusion Retrograde calf perforator flap in repairing foot and ankle wounds with significant clinical efficacy, simple operation, more secure, and ensuring the quality of life of patients, should be popularized in clinic.