中国修复重建外科杂志

中国修复重建外科杂志

选择性修薄股前外侧皮瓣修复足跟及足跟后区缺损

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目的探讨选择性修薄股前外侧皮瓣修复足跟及足跟后区缺损的疗效。方法2013 年 4 月—2015 年 8 月,收治 8 例不同原因导致的足跟及足跟后区缺损患者。男 6 例,女 2 例;年龄 15~49 岁,平均 31.2 岁。创面范围为 14 cm×10 cm~19 cm×14 cm。手术切取对侧股前外侧皮瓣,将拟覆盖足底非承重区和足跟后区部分行不同程度修薄。皮瓣切取范围为 14 cm×10 cm~19 cm×14 cm。供区游离植皮修复。结果术后皮瓣均顺利成活,创面 Ⅰ 期愈合。2 例发生供区局部皮片坏死,经换药后愈合;其余植皮均顺利成活。患者均获随访,随访时间 8~20 个月,平均 12.3 个月。患者恢复正常行走,其中 2 例皮瓣发生破损,经换药后自愈。7 例皮瓣外观无臃肿,不影响穿鞋;1 例于术后 1 年行二期皮瓣修薄术。结论选择性修薄股前外侧皮瓣修复足跟及足跟后区缺损,可获得较理想足部外观和功能。

ObjectiveTo investigate the effectiveness of selectively thinning of the free anterolateral thigh flap in repair of the heel skin and soft tissue defect.MethodsBetween April 2013 and August 2015, 8 patients with tissue defect of heel caused by different reasons were recruited. There were 6 males and 2 females with an average age of 31.2 years (range, 15-49 years). The size of wound ranged from 14 cm×10 cm to 19 cm×14 cm. All the wounds were repaired with the contralateral free anterolateral thigh flap. The partial flap which was going to repair the defects of the heel and non-weight-bearing area of planta pedis was selectively thinned. The size of flap ranged from 14 cm×10 cm to 19 cm×14 cm. The donate site was repaired by skin grafting.ResultsAll flaps survived after operation, and wounds healed by first intention. The marginal necrosis of skin graft occurred in 2 cases, and healed after changing the dressing. The other skin grafts survived. All patients were followed up 8-20 months (mean, 12.3 months). All patients could walk normally. During follow-up, 2 flaps were injured and cured after symptomatic management. The appearance of flap was good in 7 cases with no influence in wearing shoes. Only 1 patient received the second-stage surgery of thinning the flap after 1 year.ConclusionApplication of the selectively thinning of the free anterolateral thigh flap can repair the heel skin and soft tissue defects, and achieve an ideal appearance and function.

关键词: 股前外侧皮瓣; 皮瓣修薄; 足跟; 创面修复

Key words: Anterolateral thigh flap; thinning flap; heel; wound repair

引用本文: 李倩, 肖海涛, 岑瑛. 选择性修薄股前外侧皮瓣修复足跟及足跟后区缺损. 中国修复重建外科杂志, 2018, 32(3): 350-353. doi: 10.7507/1002-1892.201710074 复制

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