CAJ | 학술논문

目的探讨利用游离股前外侧穿支皮瓣或隐动脉穿支皮瓣修复足踝部软组织缺损的效果及手术技术.方法 2006年8月至2012年4月,对足踝部软组织缺损患者25例,创面范围4.0cm×5.5 cm～11.0 cm×23.0 cm.其中,足背软组织缺损采用游离股前外侧穿支皮瓣修复20例,足底软组织缺损采用游离隐动脉穿支皮瓣修复5例.结果术后25例皮瓣全部成活.术后随访3～ 50个月,平均(18.0±0.8)个月.皮瓣修复后外形大部满意,皮瓣末梢二点辨别觉为10～22 mm,股前外和隐动脉穿支皮瓣组术后3个月随访,恢复S2+以上感觉分别为13/20和5/5例.结论股前外穿支皮瓣修复足背软组织缺损较合适,隐动脉穿支用于修复足底软组织缺损.避免受区二次手术整形,重视皮瓣供区处理.负压封闭引流技术对开放性损伤导致创面的皮瓣成活有明显促进作用.
목적 탐토이용유리고전외측천지피판혹은동맥천지피판수복족과부연조직결손적효과급수술기술.방법 2006년8월지2012년4월,대족과부연조직결손환자25례,창면범위4.0cm×5.5 cm～11.0 cm×23.0 cm.기중,족배연조직결손채용유리고전외측천지피판수복20례,족저연조직결손채용유리은동맥천지피판수복5례.결과 술후25례피판전부성활.술후수방3～ 50개월,평균(18.0±0.8)개월.피판수복후외형대부만의,피판말소이점변별각위10～22 mm,고전외화은동맥천지피판조술후3개월수방,회복S2+이상감각분별위13/20화5/5례.결론 고전외천지피판수복족배연조직결손교합괄,은동맥천지용우수복족저연조직결손.피면수구이차수술정형,중시피판공구처리.부압봉폐인류기술대개방성손상도치창면적피판성활유명현촉진작용.
Objective To evaluate the surgical technique and clinical significance of the therapy for ankle soft tissue defect with 2 different flee perforator flaps.Methods Twenty-five cases of ankle soft tissue defect with exposed bone of the ankle were involved in this study from August 2006 to April 2012.and the wound sizes varied from 4.0 cm × 5.5 cm to 11.0 cm × 23.0 cm.Twenty cases with acrotarsium soft tissue defect were repaired by free anterolateral thigh perforator flap,five cases with pelma soft tissue defect were repaired by free saphenous artery perforator flap.Results All Twenty-five flaps survived.At 3 to 50 months follow-up [on an average of (18.0 ± 0.8) months] postoperatively,appearance of the flaps was satisfactory,with 10 to 22 mm in 2-PD,and the sensation percentage beyond S2+ was 13/20 cases and 5/5 cases at 3 months follow-up,respectively.Conclusion The optimal therapy for the acrotarsium soft tissue defect is the free perforator anterolateral thigh flap,and free saphenous artery perforator flap should be used for pelma soft tissue defect.Avoid secondary orthopaedic surgery,pay more attention to the donor site of the flap.VSD can significantly promoting the survival rates of the free perforator flaps if the soft defects are caused by open injury.