改良腓动脉穿支螺旋桨皮瓣修复足跟部皮肤软组织缺损

Modified peroneal artery perforator propeller skin flap for repairing the heel skin and soft tissue defects

目的探讨改良腓动脉穿支螺旋桨皮瓣修复足跟部皮肤软组织缺损的效果。方法回顾分析我院2016年5月至2018年9月期间收治的足跟部皮肤软组织缺损患者60例,按治疗方式分对照组(30例接受传统换药联合腓动脉穿支皮瓣修复)和研究组(30例接受改良腓动脉穿支螺旋桨皮瓣修复),随访患者12个月,比较治疗状况,如愈合时间、术前换药次数、治疗费用、患者满意度等。结果 研究组治疗疗效90%高于对照组66.67%(P<0.05)。比较治疗总费用,组间数据差异小(P>0.05),研究组创面完全愈合时间、术前等待时间、术前换药次数低于对照组(P<0.05);研究组总满意度86.67%高于对照组60%(P<0.05)。比较Fugl-Meyer评分,治疗前组间数据差异小(P>0.05),治疗后,研究组Fugl-Meyer评分均高于对照组(P<0.05)。结论 足跟部皮肤软组织缺损采用改良腓动脉穿支螺旋桨皮瓣方式进行修复,可一定程度保护皮瓣供区不受损害,皮瓣受区外观得到改善,恢复速度快,且具有旋转方便的优势,值的推广。

Objective To investigate the effect of modified peroneal artery perforator propeller skin flap for repairing the heel skin and soft tissue defects.Methods Retrospective analysis of 60 patients with heel skin and soft tissue defects treated in our hospital from May 2016 to September 2018.They were divided into control groups according to the treatment method (30 patients received traditional dressing changes combined with peroneal artery perforator propeller skin flap) and the research group (30 patients received modified peroneal artery perforator propeller skin flap repair),the patients were followed up for 12 months,and the treatment status was compared,such as healing time,number of preoperative dressing changes,treatment costs,and patient satisfaction.Results The therapeutic effect of the study group was 90% which is higher than that 66.67% of the control group(P<0.05).Comparing the total cost of treatment,the differences in data between the groups were small (P>0.05).The time to complete wound healing,preoperative waiting time,and number of dressing changes before surgery were lower in the study group than those in the control group (P<0.05);the total satisfaction of the study group was 86.67% which is higher than that 60% of the control group (P<0.05).Comparing the Fugl-Meyer scores,the data difference between the groups before treatment was small (P>0.05).After treatment,the Fugl-Meyer scores in the study group were higher than that in the control group (P<0.05).Conclusion The repair of skin and soft tissue defects of the heel using the modified peroneal artery perforator propeller skin flap repair technology can protect the flap donor area from damage,the appearance of the flap receiving area is improved,the recovery speed is fast,and it is convenient to rotate advantage,value promotion.