胫前动脉踝上穿支蒂皮瓣在足踝软组织缺损修复中的应用

中华显微外科杂志 Pub Date : 2020-02-25 DOI:10.3760/CMA.J.ISSN.1001-2036.2020.01.007

X. Zhai

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引用次数: 0

摘要

目的探讨以胫前动脉上踝穿支为蒂皮瓣修复足踝软组织缺损的临床效果。方法对19例足踝软组织缺损患者进行回顾性分析。在2018年4月至2019年6月期间，9名患者接受了手术，其中11名男性和8名女性，年龄21-75岁（平均39岁）。根据上踝穿孔皮瓣的解剖结构和足踝软组织缺损的大小和形状，设计并在小腿前外侧皮瓣。皮瓣大小为6.0cm×5.0cm～140cm×8.0cm。临床效果评价包括皮瓣成活率、感染控制、供区的弹性、颜色、外观和疤痕、皮肤感觉和患者满意度。还考虑了皮瓣的肿胀。结果19个皮瓣全部成活。软组织缺损及肌腱、骨、钢板外露修复效果良好。供体和受体部位均在I期愈合。门诊随访时间为2-16个月。所有皮瓣均存活良好，形态良好，颜色和弹性与附近正常皮肤非常接近。供区瘢痕面积小，足踝功能良好。结论以胫前动脉上踝穿支为蒂皮瓣修复足踝软组织缺损，取得了满意的临床效果。该皮瓣具有可靠的穿通血管，因此血液供应可靠，皮瓣成活率高。它是修复足踝软组织缺损的一种简单、安全、理想的方法。关键词：胫前动脉穿支皮瓣；上踝穿孔器；脚和脚踝；软组织缺损；修理

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Application of the flap pedicled with superior malleolus perforator of anterior tibial artery in reconstruction of soft tissue defects in foot and ankle

Objective To explore the clinical effects of the flap pedicled with superior malleolus perforator of anterior tibial artery in reconstruction of the soft defects in foot and ankle. Methods A retrospective study was carried out to analyze 19 patients with soft tissue defects in foot and ankle. Ninteen patients, which were 11 males and 8 females and aged 21-75 (mean, 39) years, received the surgery between April, 2018 and June, 2019. According to the anatomy of superior malleolus perforating flaps and the size and shape of the soft tissue defects in foot and ankle, flaps were designed and harvested in the anterolateral side of the shank. The sizes of flaps were 6.0 cm×5.0 cm-14.0 cm ×8.0 cm. Evaluation of clinical effects included flap survival, infection control, the elasticity, color, appearance and scars of the donor sites, skin sensations and patient satisfaction. The swelling of flap was also took into an account. Results All 19 flaps survived after the surgery. The soft tissue defects and exposure of tendon, bone and steel plate were repaired very well. Both the donor and recipient sites healed at stage I. Duration of out-patient clinic followed-up was 2-16 months. All flaps survived very well with good shape, and the color and elasticity were very close to the nearby normal skin. Scars at donor sites were small and the functions of ankle and foot were satisfactory. Conclusion The flap pedicled with superior malleolus perforator of anterior tibial artery in reconstruction of the soft tissue defect in foot and ankle delivered satisfactory clinical effects. This flap has reliable perforating blood vessels hence reliable blood supply with high survival rate of flaps. It is one of the simple, safe and optimal methods to repair soft tissue defects in foot and ankle. Key words: Anterior tibial artery perforator flap; Superior malleolus perforator; Foot and ankle; Soft tissue defects; Repair

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来源期刊

中华显微外科杂志

CiteScore

0.50

自引率

0.00%

发文量

6448

期刊介绍： Chinese Journal of Microsurgery was established in 1978, the predecessor of which is Microsurgery. Chinese Journal of Microsurgery is now indexed by WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 1.731 in 2017, ranking the third among all journal of comprehensive surgery. The journal covers clinical and basic studies in field of microsurgery. Articles with clinical interest and implications will be given preference.