The application of tibialis anterior muscle flap combined with stamp skin grafting and vacuum sealing drainage in the treatment of soft-tissue defect and bone exposure after distal tibial fracture

Hao-jun Wu, Hang Chen, Guang-hua Chen
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Abstract

Objective To investigate the application effect of tibialis anterior muscle flap combined with stamp skin grafting and vacuum sealing drainage in the treatment of soft-tissue defect and bone exposure after distal tibial fracture.Method 19 cases of soft-tissue defect and bone exposure after distal tibial fracture underwent tibialis anterior muscle flap transfer and vacuum sealing drainage in the first phase,stamp autologous split-thickness skin grafting and vacuum sealing drainage in the second phase.Results Muscle flap and wound granulation grow well in 18 cases after surgery,healed after stamp split-thickness skin grafting.There was 1 case of distal muscle flap necrosis,whose wound healed in the second phase after debridement dressing.Healing time of all patients varied from 10 d to 28 d,with the average of 19.5 d.Follow-up was 1 to 24 months,with the average of 12.5 months.Color,texture,flexibility of skin graft were good,with al 1 fractures healed.Conclusion Tibialis anterior muscle flap combined with stamp split-thickness skin grafting and vacuum sealing drainage is applicable to soft-tissue defect and bone exposure after distal tibial fracture. Key words: Bone exposure;  Tibialis anterior muscle flap;  Stamp skin grafting;  Vacuum sealing drainage
胫骨前肌瓣联合镫骨植皮及真空封闭引流在胫骨远端骨折软组织缺损及骨外露中的应用
目的探讨胫前肌瓣联合足部植皮及真空封闭引流在胫骨远端骨折后软组织缺损及骨外露中的应用效果。方法对19例胫骨远端骨折后软组织缺损及骨外露患者,一期行胫骨前肌瓣移植及真空封闭引流,二期行stamp自体裂厚皮移植及真空封闭引流。结果18例患者术后肌皮瓣及创面肉芽生长良好,镫骨裂皮植皮愈合。1例远端肌瓣坏死,经清创敷料后创面二期愈合。所有患者愈合时间10 ~ 28 d,平均19.5 d,随访1 ~ 24个月,平均12.5个月。植皮色泽、质地、柔韧性良好,1例骨折愈合。结论胫骨前肌瓣联合镫骨裂厚皮移植和真空封闭引流是治疗胫骨远端骨折后软组织缺损和骨外露的有效方法。关键词:骨外露;胫前肌瓣;邮票皮移植;真空密封排水
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