穿支皮瓣创面修复中存在的争议问题

Some controversial issues in wound repair with perforator flaps

创面易导致深部组织结构外露,引起持续感染和功能障碍。穿支皮瓣是创面修复最重要的方法之一,其主要优点是修复效果好、供区损伤小,临床应用日趋广泛。但穿支皮瓣在创面修复中的具体应用仍有争议,比如足背部创面的修复是选择带蒂移植还是游离移植,带蒂移植时如何切取面积更大的穿支皮瓣,带蒂移植时高位穿支和低位穿支如何选择.穿支皮瓣移植是否需要重建感觉神经等,笔者对以上问题进行归纳总结并提出应用建议。

The wound may usually lead to exposure of deep tissue and result in persistent infection and dysfunction.The perforator flap is one of the most important methods for wound repair due to the minimum morbidity of donor site and good aesthetic contour,with extensive clinical application.However,there are still some controversies regarding the clinical application of the perforator flap,such as whether the perforator flap should be pedicled transplantation or free transplantation for repairing wounds on the back of the foot,how to harvest a larger perforator flap for pedicled transplantation,how to choose perforator vessels for pedicled transplantation,and how to reconstruct the sensory function of the skin flap.In this study,the authors summarize the above problems and propose application suggestions.