保留腓动脉外踝后上穿支蒂的腓肠神经营养皮瓣修复儿童足跟皮肤软组织缺损

Keeping the peroneal artery after the lateral malleolus perforator based sural neurovascular flap repair of heel skin and soft tissue defect in children

目的探讨保留腓动脉外踝后上穿支蒂的腓肠神经营养皮瓣修复儿童足跟部皮肤软组织缺损的效果。方法将70例足跟皮肤软组织缺损患儿按照随机数字表法分为两组,对照组35例行负压封闭引流(VSD)联合游离皮瓣移植治疗,观察组35例行保留腓动脉外踝后上穿支蒂的腓肠神经营养皮瓣修复术治疗。比较两组住院时间、住院费用、治疗有效率。结果患儿均获得随访,时间6~12个月。住院时间及住院费用观察组为16.7 d±1.3 d、8 953.72元±102.35元,明显少于对照组的25.2 d±5.1 d、20 510.91元±7 481.43元,差异均有统计学意义(P<0.01)。治疗有效率:观察组为100%(好23例,一般12例),明显高于对照组的57.14%(一般20例,差15例),差异有统计学意义(P<0.01)。结论保留腓动脉外踝后上穿支蒂的腓肠神经营养皮瓣修复儿童足跟皮肤软组织缺损安全性高,预后较好,且节省住院费用。

Objective To investigate the effect of keeping on external ankle after perforators of the peroneal artery su-ral nerve nutrient of the flap to repair the skin soft tissue defect of heel in children. Methods The 70 children cases of heel skin soft tissue defect according to random number table method were divided into two groups, control group 35 cases routined closed negative pressure drainage with free flap transplantation therapy, observation group 35 cases underwent keep on external ankle after perforators of the peroneal artery for the treatment of sural nerve nutrient of the flap to repair, two groups of treatment effective rate, length of hospital stay, hospital expenses were compared. Re-sults The patients＇ postoperative follow-up time was 6 -12 months. Observation group length of hospital stay and cost of hospitalization 16. 7 d ± 1. 3 d and ￥ 8 953. 72 ± ￥ 102. 35 were significantly lower than the control group 25. 2 d ± 5. 1 d and ￥ 20 510. 91 ± ￥ 7 481. 43,the difference had statistical significance （ P 〈0. 01）. Treatment effective rate of observation group （good 23 cases, fair 12 cases） was obviously higher than that of control group （fair 20 cases, poor 15 cases） , the difference was statistically significant （P 〈0. 01）. Conclusions Keeping on externalankle after perforators of the peroneal artery sural nerve nutrient of the flap repair children foot skin and soft tissue de-fect with high safety, better prognosis, and save hospitalization expenses.