外踝上皮瓣修复足踝部皮肤软组织缺损16例

Lateral superamalleolar island flap on the repair of foot and ankle defect of skin and soft tissue: 16 cases report

目的部皮肤软组织缺损的临床疗效。方法对自2012年2月至2015年6月诊治的16例足踝部皮肤软组织缺损患者资料进行回顾性分析。所有患者入院后急诊行清创术,择期行Ⅱ期外踝上皮瓣修复术。结果本组患者平均手术时间120 min,平均术中出血量200 ml。其中,12例患者皮瓣Ⅰ期愈合;3例患者皮瓣出现皮下积血,拆除部分缝线后,症状缓解,伤口愈合;1例患者皮瓣术后3 d部分边缘坏死,切除坏死边缘并加强伤口换药处理后伤口愈合。术后随访3~8个月,平均随访时间6个月。皮瓣质地、色泽与受区周围皮肤软组织相似,不影响日常工作及生活。结论应用外踝上皮瓣修复足踝部皮肤软组织缺损效果满意,是一种可靠的治疗方法。

Objective To explore the clinical effect of lateral superamalleolar island flap on the repair of foot and ankle defect of skin and soft tissue.Methods Totally 16 cases suffered from foot and ankle defect of skin and soft tissue were collected from 2012 February to 2015 June for a retrospective analysis.All patients received emergency debridement and carried on the selective surgery of the flap repairing after the wound recovered.Results The average time of operation was 120 minutes and the loss of blood was 200 ml.The flaps were primarily healed in 12 cases.Subcutaneous hematocele and flap turning purple occurred in 3 cases and the symptoms alleviated and then the flaps healed after taking out partial stitches. The necrosis of partial edge of the flap occurred in 1 case at 3 days postoperatively,and the wound recovered when the necrotic edge of flap was cut off and intensive changing dressings was performed.All patients were followed up for 3 to 8 months with a mean duration of 6 months.The feature and color of the flap had a good similarity with the skin and soft tissue around the recipient site.The daily life was not influenced after the surgery.Conclusion It is satisfactory to cure foot and ankle defect of skin and soft tissue with lateral superamalleolar island flap,which is a reliable treatment.