CAJ | 학술논문

目的探讨采用(足母)趾腓侧皮瓣修复前足微小面积皮肤缺损的疗效.方法回顾性分析2003年9月至2012年6月,采用(足母)趾腓侧皮瓣顺行转移修复12例前足微小面积皮肤缺损患者资料,男9例,女3例；年龄19～55岁,平均27岁；左侧4例,右侧8例；(足母)趾背侧3例,跖侧9例.创面类型:外伤4例,肿瘤4例,溃疡2例,瘢痕2例.皮肤缺损面积:1.3 cm×0.5 cm～2.5 cm×2.0 cm,切取皮瓣面积:1.5 cm×0.8 cm～3.0 cm×1.5 cm.设计的(足母)趾腓侧皮瓣宽度均＜1.5 cm,皮瓣带(足母)趾腓侧趾动脉和趾神经.皮肤缺损均一期修复.皮瓣供区直接缝合.术后从皮瓣愈合、皮瓣感觉、皮瓣形态、供区瘢痕、负重行走感受五个方面对术后疗效进行满意度评价.结果 12例皮瓣全部成活,无一例发生皮缘坏死、感染及血管危象.伤口均一期愈合.9例患者获得随访,随访时间3～96个月,平均12个月.末次随访时皮瓣质地柔软,皮肤颜色正常,无磨损及破溃,无须二期整形；皮瓣感觉正常,两点辨别觉为4～10 mm.皮瓣供区切口均愈合,瘢痕隐蔽,未影响患者行走及负重功能.术后患者均对疗效表示满意.结论 (足母)趾腓侧皮瓣顺行转移修复前足微小面积皮肤缺损,具有皮瓣耐磨、有神经支配、皮瓣感觉正常、解剖位置恒定、供区隐蔽、能恢复正常的行走和负重功能等优点,是修复足趾及前足跖底负重区微小面积皮肤缺损的好方法.
목적 탐토채용(족모)지비측피판수복전족미소면적피부결손적료효.방법 회고성분석2003년9월지2012년6월,채용(족모)지비측피판순행전이수복12례전족미소면적피부결손환자자료,남9례,녀3례；년령19～55세,평균27세；좌측4례,우측8례；(족모)지배측3례,척측9례.창면류형:외상4례,종류4례,궤양2례,반흔2례.피부결손면적:1.3 cm×0.5 cm～2.5 cm×2.0 cm,절취피판면적:1.5 cm×0.8 cm～3.0 cm×1.5 cm.설계적(족모)지비측피판관도균＜1.5 cm,피판대(족모)지비측지동맥화지신경.피부결손균일기수복.피판공구직접봉합.술후종피판유합、피판감각、피판형태、공구반흔、부중행주감수오개방면대술후료효진행만의도평개.결과 12례피판전부성활,무일례발생피연배사、감염급혈관위상.상구균일기유합.9례환자획득수방,수방시간3～96개월,평균12개월.말차수방시피판질지유연,피부안색정상,무마손급파궤,무수이기정형；피판감각정상,량점변별각위4～10 mm.피판공구절구균유합,반흔은폐,미영향환자행주급부중공능.술후환자균대료효표시만의.결론 (족모)지비측피판순행전이수복전족미소면적피부결손,구유피판내마、유신경지배、피판감각정상、해부위치항정、공구은폐、능회복정상적행주화부중공능등우점,시수복족지급전족척저부중구미소면적피부결손적호방법.
Objective To explore the curative effect of the treatment for minor-size tissue defect of forefoot by pedicle fibular side flap of the hallux.Methods The data of 12 patients with minor-size tissue defect of forefoot was retrospectively analyzed who were repaired with fibular side flap of the hallux from September 2003 to June 2012.There were 9 males and 3 females,with an average of 27 years (range,19-55 years).Among them,4 injured on the left,8 on the right side; 3 on the dorsal side and 9 on the plantar.There were 4 cases of traumatic wound,4 of tumor,2 of ulcer,and 2 of scar.Sizes of tissue defect were 1.3 cm×0.5 cm-2.5 cm×2.0 cm,the minimal flap size was 1.5 cm×0.8 cm,and the maximal flap size was 3.0 cm×1.5 cm.All flaps were elevated with fibular side artery and nerve of the hallux,and with width less than 1.5 cm,so wound of donor site could be sutured directly.The postoperative curative effect was assessed from five respects including flap healing,the sensation of the flaps,the flap appearance,the scar and weight-bearing walking.Results This kind of flap all survived successfully in the 12 cases,with satisfying cosmetic effect and sensory,without skin necrosis and blood vessel crisis.Nine patients were followed up for 3-96 months (average,12 months).The flaps were covered with soft and intact normal colored skin,no abrasion or wearing out happened and no subsequent reshaping was needed in the last follow-up.The minor-sized donor site wound could be sutured up directly.Since donor site was selected from non-weight-bearing area,walking and weight-bearing function of the patients were nearly unaffected at all.Sensory of the flaps were normal,with two-point discrimination ranging between 4-10 mm.Conclusion Due to the advantages of thinness,nerve nourishing,constant anatomical position and hidden position of donor site,anterograde fibular side flap of the hallux can be an ideal choice in repairing minor-size tissue defect of forefoot.