游离腓动脉穿支皮瓣修复手足部软组织缺损的疗效观察

Curative effect observation of free peroneal artery perforator flap to repair the soft tissue defect of feet and hands

目的 探讨游离腓动脉穿支皮瓣修复手足外伤软组织缺损的方法和疗效.方法 2009年1月-2013年12月,应用游离腓动脉穿支皮瓣修复手足外伤后软组织缺损11例,软组织缺损面积5.5 cm×6.0cm～7.0 cm× 11.0 cm,平均面积6.5 cm×9.0 cm.入院后清创、骨折内固定,切取同侧腓动脉穿支皮瓣修复,供区游离全厚皮片植皮.结果 术后随访3～12个月,平均6个月,疗效满意,11例皮瓣全部成活,创面Ⅰ期愈合10例,1例感染病例术后6周愈合,皮瓣质地柔软,无磨损及破溃,外观臃肿不明显,供区植皮成活.结论 手足外伤后软组织缺损行游离腓动脉穿支皮瓣修复可获得满意的疗效,符合“受区修复重建好,供区破坏损伤小”的组织修复原则.

Objective To explore the methods and curative effect of free peroneal artery perforator flap to repair the soft tissue defect in the hands and feet. Methods Since January 2009 to December 2013, 11 cases with soft tissue defects were treated in our department with free peroneal artery perforator flap. They were 10 males and 1 female; with an average age of 42 （rang from 30 to 51）, Soft tissue defect in the area was 5.5 cm× 6.0 cm × 7.0 cm ×11.0 cm, the average area of6.5cm ×9.0cm. The soft tissue infection was in 2 cases. Debridement, internal fixation of fracture after admission. After wound was clean, using ipsilateral peroneal artery perforator flap to repair defects and skin grafts in the donor. Results All cases were followed up from 3 months to 12 months （mean 6 months）. All flaps survived well. 10 cases obtained primary healing, 1 case of infections healed after 6 weeks, the flap was soft, no wear and burst, with satisfactory appearance, the skin graft survived. Conclusion The free peroneal artery perforators flap in repairing the defects can obtain satisfactory curative effect. This accords with the principle of ＂recipient sites repair well, reduce the damage in the donor sites.