下肢损伤性溃疡的综合治疗

The Combination Management in the Traumatic Ulcer Treatment of the Lower Extremity

目的探讨下肢在损伤后创面溃疡的较理想的治疗方法。方法对84例患者采用非手术治疗19例,手术治疗65例,其中邮票状植皮14例、大张植皮31例、皮瓣移植20例。结果随访6～18个月,溃疡创面全部愈合,皮片成活,皮瓣质地良好,外观及功能较满意。结论下肢损伤性溃疡较难治愈,根据溃疡的部位、面积、深浅及手术者的经验,采用手术和非手术综合治疗,是一种可行的方法。

To find out the optimal therapy for the lower extremity traumatic ulcer.Methods Among 84 patients involved,19 had non-operation therapy and 65 had operation(14 cases with post stamp split skin graft,31 cases with big piece skin graft and 20 cases with pedicle skin flap).Results Follow-up 6～18 months,all of ulcers were healed,the skin graft or skin flap survived,the appearance,texture and function of the flap were satisfactory.Conclusions The combination management with non-surgical and surgical treatment is the optimal therapy for the lower extremity traumatic ulcer.The combination varies depend on position,size and depth of the lesion and the experience of the attending surgeon.