应用足跟外侧皮瓣修复跟腱区Ⅳ度烧伤创面的效果观察

The effect of use of lateral foot flap in repairing Ⅳ degree burn wound of Achilles' tendon region

目的:探讨应用足跟外侧皮瓣修复跟腱区Ⅳ度烧伤的临床效果。方法:2008年2月—2014年8月,应用足跟外侧皮瓣修复16例跟腱区Ⅳ度烧伤创面,所有创面均有肌腱外露或坏死。创面面积4 cm×3 cm^5 cm×4 cm,切取皮瓣面积5 cm×4 cm^6 cm×5 cm,皮瓣供区均行中厚皮片移植修复。结果:16例患者术后皮瓣血液循环良好,无血管危象发生;所有患者均得到随访,随访时间6~18个月,皮瓣全部一期成活,蒂部无臃肿及猫耳朵畸形,皮瓣外形满意,质地柔软,色泽与周围皮肤相近。结论:跟外侧皮瓣具有皮肤质地好、有感觉、外形不臃肿、血管易解剖、转移灵活方便等优点,是修复跟腱区Ⅳ度烧伤创面的一种简单、有效的方法。

Objective： To observe the clinical effect of using lateral foot flap in repairing IV degree burn wound of Achilles＇ tendon region. Methods： Sixteen patients with the soft tissue defects produced by burn injury in Achilles＇ tendon region were hospitalized from February 2008 to August 2014, and they were repaired with lateral foot flap. All the patients suffered from exposure or necrosis of the Achilles＇ tendon. The area of the wounds ranged from 4 cmx3 cm to 5 cmx4 cm. The area of the flaps ranged from 5 cmx4 cm to 6 cmx5 cm. Donor site of the flaps were covered with medium- thickness skin graft. Results： Flaps survived in all the patients with good circulation, and no vascular crisis was observed. All the patients were followed up for 6 to 18 months. All the flaps survived by first intension, without swollen pedicle or ＂cat ear＂ deformity. The contour of the flaps was good, and there was no difference in the texture and colour between the flaps and site of reception in Achilles＇ tendon region. Conclusions： Repairing IV degree burn wounds in Achilles＇ tendon region with lateral foot flaps possesses such advantages as good appearance, preservation of feeling, satisfactory appearance, easy dissection of the vessels, flexibility in rotation, etc. It is a simple and effective method.