游离穿支皮瓣修复创伤性前足皮肤缺损疗效评价

Efficacy evaluation for traumatic forefoot tissue loss reconstruction with free perforator flaps

目的探讨游离穿支皮瓣修复创伤性前足皮肤缺损的治疗效果。方法选取41例创伤性前足缺损患者,采用游离穿支皮瓣进行修复。本组使用5种游离穿支皮瓣进行修复,游离股前外侧穿支皮瓣32例,游离腓动脉穿支皮瓣2例,游离臂外侧穿支皮瓣5例,游离臂内侧穿支皮瓣1例,游离胸背动脉穿支皮瓣1例。结果患者随访(26.7±9.3)个月,38例术后愈合顺利,3例术后探查,1例愈合,2例失败。修复后的前足功能和外形满意。结论游离穿支皮瓣修复前足,外形满意,负重恢复和步态良好。

Objective To explore the treatment outcome of traumatic forefoot tissue loss reconstructions with free perforator flaps. Methods A total of 41 patients underwent traumatic forefoot tissue loss reconstructions with free perforator flaps.There were 5 types of free perforator flaps to be used in reconstructions： 32 cases of free anterolateral thigh perforator flaps,2 cases of free fibular flaps,5 cases of free lateral arm perforator flaps,1 case of free medial arm perforator flap and 1 case of free thoracodorsal artery perforator flap. Results Patients were followed up for（ 26. 7 ± 9. 3） months. There were 38 cases postoperative healed well,3 cases to be re-explored,1 case healed and 2 cases failed. The overall functional and cosmetic outcomes were excellent. Conclusion Forefoot reconstruction with a free perforator flap provides satisfactory cosmesis,normal weight-bearing and gait good function.