目的 探讨足跟部皮肤缺损修复的围手术期处理。方法 本组46例,采用6种不同类型轴型皮瓣、肌皮瓣进行修复。其中足底内侧皮瓣14例,趾短屈肌皮瓣4例,口止母展肌皮瓣3例,背阔肌皮瓣7例,小腿内侧远端胫后动脉皮肤穿支皮瓣16例,足背皮瓣2例。结果 手术全部成功,随访3个月~4年,43例皮瓣有良好感觉功能,负重后无溃疡发生。3例感觉功能差,其中1例负重后皮瓣肿胀,有水泡形成。结论 修复方法根据病情而定,带蒂皮瓣注意保护好神经,受区皮肤感觉对负重功能有决定意义
OBJECTIVE: To investigate the efficacy of different flaps in the treatment of skin defect of hell. METHODS: Forty-six patients with skin defect of hell were adopted in this study. There were 39 males and 7 females, 29 years old in average. Six different flaps were applied in the reconstructive operation, 14 plantaris medialis flaps, 4 flexor digitorum brevis muscle flaps, 3 abductor hallucis flaps, 7 latissimus dorsi flaps, 16 distal medialis flaps of leg pedicled with the cutaneous branch of posterior fibial artery, 2 foot dorsum flaps. RESULTS: All the flaps survived, primary healing of the wound in 45 cases and secondary healing in 1 case. Followed up for 3 months to 4 years, 43 patients obtained good flap sensation, the function of weight bearing were satisfied in 43 patients. CONCLUSION: The six different flaps should be applied according to patient’s condition individually. The sensation of flap is very important to the function of weight bearing.
Key words: Heel; Skin defect; Repair; Perioperative period
引用本文: 刘进炼,张卫平,王占长,刘长安,步建立,康强军. 足跟部皮肤缺损一期修复的围手术期处理. 中国修复重建外科杂志, 2000, 14(4): 232-233. doi: 复制