游离背阔肌肌瓣移植修复足背部软组织缺损的疗效探讨

Study on the Effect of Free Latissimus Dorsi Muscle Flap Transplantation in the Repair of Soft Tissue Defects in Dorsal Foot

目的:探究采用游离背阔肌肌瓣移植修复足背软组织缺损的美学效果。方法:选取笔者医院2019年6月-2020年6月收治的足背部软组织缺损患者180例为研究对象,采用随机数表法将其分为对照组与观察组,各90例。对照组行传统背部皮瓣游离移植术进行修复,观察组行修薄背阔肌肌瓣游离移植修复,对比分析两组患者术后皮瓣肿胀及感觉功能情况,并对治疗效果及患者美学效果满意度进行评价,统计术后并发症发生情况。结果:术后3个月,观察组皮瓣肿胀情况明显优于对照组,差异有统计学意义(P<0.05)。观察组临床治疗总有效率为88.89%,美学效果满意度评分(7.03±0.47)分,对照组总有效率77.78%,美学效果满意度评分(6.26±0.69)分,组间比较差异均有统计学意义(P<0.05)。观察组两点辨距觉大于对照组,其感觉功能恢复情况也优于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为3.33%低于对照组的12.22%,差异有统计学意义(P<0.05)。结论:与传统背部皮瓣游离移植术比较,修薄背阔肌肌瓣游离移植治疗效果显著,可有效避免皮瓣和肌瓣移植后臃肿的缺点,促进患者感觉功能的恢复,患者对移植后的外观及美学效果满意度较高。

Objective To explore the cosmetic results of free latissimus dorsi muscle fl ap transplantation in repairing soft tissue defect of dorsal foot. Methods 180 patients with soft tissue defect of dorsal foot admitted to the hospital between June 2019and June 2020 were selected, and divided into the control group and the observation group by random number table method,90 cases in each group. The control group underwent traditional free back fl ap transplantation, while the observation group underwent thinned free latissimus dorsi muscle fl ap transplantation. The skin fl aps swelling and sensory function recovery in the two groups after operation were compared. Treatment ef fects and patient satisfaction were evaluated, and the incidence of postoperative complications was counted. Results Three months after operation, the skin fl ap swelling in the observation group was signifi cantly better than that in the control group, the dif ference was statistically signifi cant(P<0.05). The clinical response rate and satisfaction score of the observation group were 88.89% and(7.03±0.47), higher than those in the control group [77.78%,(6.26±0.69), P<0.05]. The observation group had better two-point discrimination ability and sensory function than the control group(P<0.05). The incidence of postoperative complications in the observation group was 3.33%, signifi cantly lower than that in the control group(12.22%, P<0.05). Conclusion Compared with traditional free back fl ap transplantation, thinned free latissimus dorsi muscle fl ap transplantation can achieve more signifi cant therapeutic ef fects, which can ef fectively avoid bloated characteristics after skin fl ap and muscle fl ap transplantation, and promote the recovery of sensory function. Besides,the patients are more satisfi ed with the appearance and cosmetic results after transplantation.