带筋膜瓣的腓动脉穿支螺旋桨皮瓣修复合并死腔的足踝部创面

Propeller flap with adipofascial tissue based on peroneal artery perforator for repairing the wound with a dead space in foot and ankle

目的 探讨带筋膜瓣的腓动脉穿支螺旋桨皮瓣修复合并死腔的足踝部创面的可行性.方法 2013年1月至2014年12月收治伴有死腔的足踝部创面12例,彻底清创后,设计带筋膜瓣的腓动脉穿支螺旋桨皮瓣进行修复,筋膜瓣填塞死腔,螺旋桨皮瓣覆盖创面,供区直接拉拢缝合.结果 本组皮瓣切取面积为4cm×10cm～7cm×16cm,筋膜瓣面积2cm×4 cm ～5cm ×7cm.所有病例皮瓣全部存活,术后未发生感染,皮瓣供区一期愈合.术后随访5 ～21个月,平均8个月,皮瓣色泽正常,外形与质地良好,踝关节功能满意,感染无复发,供区仅遗留线性瘢痕.结论 带筋膜瓣的腓动脉穿支螺旋桨皮瓣是一种修复合并死腔的足踝部创面较为理想的方法.

Objective To explore the feasibility of the propeller flap withadipofascial tissue based on peroneal artery perforator for repairing the wound with a dead space in foot and ankle.Methods Between January 2013 to December 2014,12 wounds with a dead space in foot and ankle were treated with the propeller flap with adipofascial tissue based on peroneal artery perforator after thorough debridement.The adipofascial tissue was used to fill the dead space,the propeller flap was used to cover the superficial wound.The defect at donor site was closed directly.Results The size of the propeller flap based on peroneal artery perforator ranged from 4 cm × 10 cm to 7 cm × 16 cm,the size of the adipofascial flap ranged from 2 cm × 4 cm to 5 cm × 7 cm.All flaps survived completely and the wounds healed primarily.The defects at donor sites got primary healing without complications.All patients were followed up for 5 to 21 months with an average of 8 months without recurrence of infection during the follow-up period.The appearance,texture,and color of the flaps were similar to those of the recipient sites.Good function of ankle was achieved.Conclusions The propeller flap with adipofascial tissue based on peroneal artery perforator is a good option for reconstruction of foot and ankle wounds with dead space.