游离膝降动脉皮瓣修复同侧足部皮肤软组织缺损

Free descending genicular artery flap for repairing skin and soft tissue defects on the ipsilateral foot

目的探讨游离膝降动脉皮瓣修复足部皮肤软组织缺损的安全性和临床疗效。方法对2013年1月-2018年10月收治11例足部创面采用游离膝降动脉皮瓣进行修复。结果术后11例皮瓣全部一期成活,无皮瓣肿胀及皮下血肿出现,无局部坏死。随访3~36个月,平均8个月,皮瓣质地与足部接近,无二次手术修薄病例,术后感觉恢复S2~S4,均恢复行走功能;5例供区直接缝合,愈合良好,6例供区植皮均成活。术后3个月依据HSS评分膝关节功能评定为优,患者满意率达到88%。结论应用游离膝降动脉皮瓣转移修复前足创面是一种安全可行的方法,临床疗效满意。

Objective To study the safety and clinical efficacy of free descending genicular artery flap for repairing skin and soft tissue defects in the foot.Methods From January 2013 to October 2018,11 patients with foot wounds requiring flap repair were collected.All defects were repaired with free descending genicular artery flap.Results A total of 11 patients were included,and all the patients received free descending genicular artery flap to repair the defects.All 11 flaps survived in one stage,no flap swelling and subcutaneous hematoma appeared,and no local necrosis occurred.Follow-up was performed.3 to 36 months,with an average follow-up of 8 months.The cosmetic results of the flap were close to that of the foot.No cases received thinning operation after the first operation.Postoperative sensations recovered from S2 to S4.All 11 patients,walking function recovered;the donor site was sutured directly and healed well in 5 patients.Six patients underwent skin grafting,and all skin grafts survived.There was no significant difference in knee function according to HSS scores before and three months after surgery.The patient satisfaction rate reached 88%.Conclusion The free descending genicular artery flap is a safe and feasible method to repair the forefoot wound,and the clinical effect is satisfactory.