旋转点下移的外踝上皮瓣修复足内侧皮肤软组织缺损

Repairment of medial skin and soft tissue defect of foot with lateral supramalleolar flap with downward rotation point

目的报道以旋转点下移的外踝上皮瓣修复足内侧皮肤软组织缺损的临床效果。方法2018年2月-2020年6月,对13例足内侧皮肤软组织缺损(创面最远达第1跖骨近1/3,近端达内踝前缘)的创面进行修复,切取面积:3.0 cm×5.0 cm~6.0 cm×10.0 cm。结果11例皮瓣完全成活,2例皮瓣远端出现部分坏死,经换药后创面愈合。经6周~12个月随访,皮瓣质地优良,无臃肿,外观及功能均满意。结论旋转点下移的外踝上皮瓣是修复足内侧皮肤软组织缺损的理想皮瓣之一,该皮瓣操作相对简单,供区损伤较小,皮瓣质地和前足皮肤相近,皮瓣较美观、无臃肿、无需二期整形,适合临床推广应用。

Objective To report the effect of lateral supramalleolar flap with downward rotation point on repairment of medial skin and soft tissue defect of foot.Methods The wounds of 13 patients with medial skin defect of foot(the farthest wound was up to 1/3 of the first metatarsal,and the proximal end was located at the anterior margin of medial malleolus)were repaired.the largest area cut was 3.0 cm×5.0 cm~10.0 cm×6.0 cm.Results Eleven flaps survived completely,2 flaps showed distal part necrosis.After dressing change,the wounds healed.After follow-up of 6 weeks to 12 months,the flaps had good texture,no bloating,and satisfactory appearance and function.Conclusion The lateral supramalleolus flap with downward rotation point is one of the ideal flaps for medial foot defect.The operation of this flap is relatively simple,the injury in the donor site is relatively small,the texture of the flap is similar to that of the forefoot skin,and the flap is beautiful and free of bloating.No two-stage plastic surgery is required,so it has a wide application prospect.