逆行缝匠肌肌皮瓣修复小腿截肢残端创面

Repairing wounds of stumps after limb amputation below knee joint with reverse sartorius myocutaneous flaps

目的探讨逆行缝匠肌肌皮瓣修复小腿截肢残端创面的临床效果。方法回顾分析2008年10月至2017年10月北京积水潭医院采用逆行缝匠肌肌皮瓣转移修复21例伴有胫骨外露的小腿截肢残端创面患者的临床资料。创面大小为16 cm×6 cm～21 cm×9 cm,皮瓣大小为18 cm×8 cm～23 cm×10 cm。结果 21例患者肌皮瓣全部成活。其中2例出现肌皮瓣远端表层坏死,经过换药治疗后创面二期愈合。全部病例的皮瓣供瓣区均直接缝合。随访时间为1～3年。患者佩戴义肢后创面耐磨性良好,无破溃,小腿残端外观良好。结论采用逆行缝匠肌肌皮瓣修复伴有胫骨外露的小腿截肢残端创面是一种有效的方法,临床效果良好。

Objective To investigate the effect of repairing wounds of stumps after limb amputation below knee joint with reverse sartorius myocutaneous flaps. Methods A total of 21 patients with tibial exposure of stumps after limb amputation below knee joint were repaired with reverse sartorius myocutaneous flaps in Beijing Jishuitan Hospital from October 2008 to October 2017. The size of wounds surface were from 16 cm ×6 cm to 21 cm × 9 cm,and the area of the flaps were from 18 cm × 8 cm to 23 cm × 10 cm. Results All the reverse sartorius myocutaneous flaps survived. Of which 2 flaps were necrosis in the distal surface,and the wounds healed after dressing changes. All the donor sites healled well. The cases were followed-up for 1-3 years. All the 21 patients had good prosthesis adaptability and the stump shapes were good with no ulceration.Conclusion Using reverse sartorius myocutaneous flaps is an ideal method for repairing amputation stumps with tibial exposure.