小腿岛状穿支蒂螺旋桨皮瓣与股前外侧皮瓣修复足踝部复合组织缺损对比分析

Comparative Analysis of Pedicled Perforator Island Propeller Flap of Lower Leg and Anterolateral Thigh Flap in Repairing Composite Tissue Defect of Foot and Ankle

目的:比较小腿岛状穿支蒂螺旋桨皮瓣与股前外侧皮瓣修复足踝部复合组织缺损的疗效。方法:按照随机数字表法将2019年1月-12月笔者医院收治的40例足踝部复合组织缺损患者分为A组与B组,每组20例。A组患者采用小腿岛状穿支蒂螺旋桨皮瓣进行修复,B组患者采用股前外侧皮瓣进行修复,术后随访12个月。比较两组的手术时间、皮瓣愈合时间、皮瓣成活率、术后并发症发生率、AOFAS踝-后足评分及皮瓣感觉评分。结果:两组的皮瓣成活率均为100.00%,B组的手术时间、皮瓣愈合时间均明显短于A组,差异具有统计学意义(P<0.05)。A组与B组的术后并发症发生率分别为15.00%、10.00%,两组之间比较差异无统计学意义(P>0.05)。随访结束时,两组的AOFAS踝-后足评分、皮瓣感觉评分均较术前明显增高(P<0.05),B组的增加幅度更加明显(P<0.05)。结论:股前外侧皮瓣对足踝部复合组织缺损的修复效果优于小腿岛状穿支蒂螺旋桨皮瓣。

Objective To compare the curative effect between pedicled perforator island propeller flap of lower leg and anterolateral thigh flap in repairing composite tissue defect of foot and ankle.Methods According to the random number table method,40 patients with composite tissue defect of foot and ankle who was divided into group A and group B in our hospital from January to December 2019,with 20 patients in each group.The patients were repaired with pedicled perforator island propeller flap of lower leg in group A,while the patients were repaired with anterolateral thigh flap in group B.All the patients were followed up for 12 months after operation. The operative time, flap healing time, flap survival rates, incidence rates of postoperative complications, scores of AOFAS ankle-hind foot and flap sensory scores were compared between two groups. Results The flap survival rates were 100.00% in both groups. The operative time, flap healing time in group B was significantly shorter than that in group A,the difference is statistically significant(P <0.05). The incidence ratesof postoperative complications were 15.00% and 10.00% in groupA and Group B, respectively, with no statistically significant difference between the two groups(P >0.05). At the end of following-up, the scores of AOFAS ankle-hind foot and flap sensory scores in both groups were significantly higher than those before operation(P <0.05), and the increased amplitude was more significant in group B(P <0.05). Conclusion The anterolateral thigh flap was more effective than the pedicled perforator island propeller flap of lower leg in repairing composite tissue defect of foot and ankle.