腓肠神经营养血管皮瓣修复术联合封闭式负压引流在足跟部软组织缺损修复中的应用效果

Application effect of sural neurovascular flap repair combined with vacuum sealing drainage in the repair of heel soft tissue defect

目的探讨腓肠神经营养血管皮瓣修复术联合封闭式负压引流(VSD)在足跟部软组织缺损修复中的应用效果。方法随机将2018年1月至2019年3月在我院进行足跟部软组织缺损修复的58例患者分为观察组(29例,腓肠神经营养血管皮瓣修复+VSD)与对照组(29例,腓肠神经营养血管皮瓣修复+常规换药)。比较两组患者的疗效。结果术后10 d,两组患者WBC、PLT及CRP水平均下降,且观察组低于对照组(P<0.05)。观察组换药次数、创面愈合时间、住院天数优于对照组(P<0.05),皮瓣成活率高于对照组(P<0.05),并发症总发生率低于对照组(P<0.05)。术后6个月,观察组瘢痕评分低于对照组,足功能评分高于对照组(P<0.05)。观察组治疗总有效率高于对照组(P<0.05)。结论腓肠神经营养血管皮瓣修复术联合VSD治疗足跟部软组织缺损可更快消除炎症,提高皮瓣成活率,降低并发症发生率及瘢痕评分,有利于患者足功能恢复。

Objective To investigate the application effect of sural neurovascular flap repair combined with vacuum sealing drainage(VSD)in the repair of heel soft tissue defect.Methods Fifty-eight patients with heel soft tissue defect repaired in our hospital from January 2018 to March 2019 were randomly divided into observation group(29 cases,sural neurovascular flap repair+VSD)and control group(29 cases,sural neurovascular flap repair+routine dressing change).The curative effects of the two groups were compared.Results At 10 days after operation,the WBC,PLT and CRP levels of the two groups decreased,and those of the observation group were lower than the control group(P<0.05).The number of dressing changes,wound healing time and hospitalization days in the observation group were better than those in the control group(P<0.05),the survival rate of skin flaps was higher than that in the control group(P<0.05),and the total incidence of complications was lower than that in the control group(P<0.05).At 6 months after operation,the scar score of the observation group was lower than that of the control group,and the foot function score was higher than that of the control group(P<0.05).The total effective rate of treatment in the observation group was higher than that of the control group(P<0.05).Conclusion The sural neurovascular flap repair combined with VSD in the treatment of heel soft tissue defects can quickly eliminate inflammation,improve the survival rate of skin flap,reduce the incidence of complications and scar score,which is conducive to the recovery of foot function.