邻近肌瓣联合VSD植皮一期修复胫前骨外露创面

Reconstruction of tibial exposure with local muscular flap, VSD and skin transplantation

目的 探讨一种修复胫前骨外露创面的方法.方法 根据骨外露部位的不同,将39例外伤后伴有胫骨外露患者分为上、中、下3个区域,针对不同区域选择合适的肌瓣覆盖骨外露创面后,同期行VSD植皮修复创面,1周后拆除负压封闭引流装置.结果 39例胫骨外露创面所移植肌瓣、植皮均成活,2例表皮轻度糜烂,换药后愈合.术后随访3～6个月,创面愈合良好,下肢行走正常.结论 选择合适肌瓣联合VSD植皮一期修复胫骨外露创面,可提高手术成功率,减轻患者痛苦,缩短了疗程,是治疗该类创面的简便、有效的方法.

Objective To investigate the treatment for tibial exposure wounds.Methods 39 patients with tibial exposure wounds were divided into three groups according to the exposure location （upper,medium and below）.The local muscular flaps were designed to cover the tibial exposure,followed by skin grafts and VSD.VSD was removed one week later.Results All the muscular flap and skin graft survived.Mild epidermis erosion happened in 2 cases,which healed spontaneously after dressing.The patients were followed up for 3-6 months with good healing and no walking malfunction.Conclusions The local muscular flap combined with skin graft and VSD is a simple and effective method for tibial exposure wound with short healing time and high successful rate.