腓动脉穿支蒂螺旋桨皮瓣修复跟骨骨折术后L形感染创面17例

Treatment of postoperative infected unhealed wounds in calcaneus fractures using L-shaped flap pedicled with peroneal artery perforator

目的探讨腓动脉穿支L形皮瓣治疗跟骨骨折术后外侧L形切口愈合不良的临床疗效及应用。方法2013年10月至2015年3月，采用一期扩创、载抗生素硫酸钙人工骨填充、腓动脉穿支蒂L形皮瓣修复治疗跟骨骨折术后外侧L形切口愈合不良患者17例。皮瓣面积8 cm×2 cm～11 cm×3 cm，供区均直接缝合。结果17例患者均获随访，时间6～18个月，平均11.5个月，所有患者感染有效治愈，皮瓣成活良好，弹性好，无瘢痕挛缩，外观满意，足踝关节活动正常。结论腓动脉穿支蒂L形皮瓣在治疗跟骨骨折术后外侧L形切口愈合不良的应用中，因形制宜，贴合切口，针对性强，疗效优良，具有较大的推广价值。

ObjectiveTo summarize and explore the clinical effect and application of L-shaped flap pedicled with peroneal artery perforator in the treatment of unhealed lateral L-shaped incision after calcaneal fractures.MethodsFrom October 2013 to March 2015, 17 patients with unhealed L-shaped incision after calcaneal fractures were treated with one-stage thorough debridement, artificial bone filling with antibiotics-laden calcium sulphate and L-shaped flap pedicled with peroneal artery. Flap areas ranged from 8 cm × 2 cm to 11 cm × 3 cm. Donor sites are primarily sutured.ResultsAll 17 patients were followed up for 6 to 18 months with an average of 11.5 months. All patients with infection were cured effectively, demonstrating well survived flaps with normal elasticity and pigmentation, no scar contracture, satisfactory appearance and normal ankle joint motility.ConclusionsL-shaped flap pedicled with peroneal artery perforator was an effective method in the treatment of unhealed lateral L-shaped incision after calcaneal fractures. It was suitable for coverage of the unhealed wound and worthy of being popularized.