中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
CHINESE JOURNAL OF PLASTIC SURGERY
2013年
5期
341-344
,共4页
李心怡%李小静%宁金龙%左宗宝
李心怡%李小靜%寧金龍%左宗寶
리심이%리소정%저금룡%좌종보
足底%穿支皮瓣%创伤和损伤
足底%穿支皮瓣%創傷和損傷
족저%천지피판%창상화손상
Plantar%Perforator flap%Wounds and injuries
目的 探讨应用足底角形穿支皮瓣修复足跟及前跖底缺损的方法及临床效果.方法 以缺损部位为皮瓣头端设计角形穿支筋膜皮瓣,弓形侧及凹陷侧均应切开深筋膜,并携带跖腱膜,将其旋转推进覆盖创面,皮瓣内尽可能包含2～3个穿支血管,必要时可结扎源血管(足底外侧动脉或足底内侧动脉),以利于增加皮瓣旋转推进距离.2010年1月至2012年10月,设计应用角形穿支皮瓣修复7例足底皮肤缺损,缺损范围约1.5 cm×2.0 cm～4.0 cm×5.0cm,皮瓣切取面积为7 cm×3 cm～13 cm× 7 cm.结果 术后6例角形穿支皮瓣全部成活,另1例皮瓣远端出现裂开坏死,残留小创面经换药、二期全层皮片移植愈合.供、受区伤口愈合良好,经3个月至2年随访,色泽、质地、外形及功能均恢复较好.结论 应用足底角形穿支皮瓣,供区缺损无需切取皮片移植,由足底同源性厚实坚韧皮肤修复,是修复足底部负重区软组织缺损的一种较优越方法.
目的 探討應用足底角形穿支皮瓣脩複足跟及前蹠底缺損的方法及臨床效果.方法 以缺損部位為皮瓣頭耑設計角形穿支觔膜皮瓣,弓形側及凹陷側均應切開深觔膜,併攜帶蹠腱膜,將其鏇轉推進覆蓋創麵,皮瓣內儘可能包含2～3箇穿支血管,必要時可結扎源血管(足底外側動脈或足底內側動脈),以利于增加皮瓣鏇轉推進距離.2010年1月至2012年10月,設計應用角形穿支皮瓣脩複7例足底皮膚缺損,缺損範圍約1.5 cm×2.0 cm～4.0 cm×5.0cm,皮瓣切取麵積為7 cm×3 cm～13 cm× 7 cm.結果 術後6例角形穿支皮瓣全部成活,另1例皮瓣遠耑齣現裂開壞死,殘留小創麵經換藥、二期全層皮片移植愈閤.供、受區傷口愈閤良好,經3箇月至2年隨訪,色澤、質地、外形及功能均恢複較好.結論 應用足底角形穿支皮瓣,供區缺損無需切取皮片移植,由足底同源性厚實堅韌皮膚脩複,是脩複足底部負重區軟組織缺損的一種較優越方法.
목적 탐토응용족저각형천지피판수복족근급전척저결손적방법급림상효과.방법 이결손부위위피판두단설계각형천지근막피판,궁형측급요함측균응절개심근막,병휴대척건막,장기선전추진복개창면,피판내진가능포함2～3개천지혈관,필요시가결찰원혈관(족저외측동맥혹족저내측동맥),이리우증가피판선전추진거리.2010년1월지2012년10월,설계응용각형천지피판수복7례족저피부결손,결손범위약1.5 cm×2.0 cm～4.0 cm×5.0cm,피판절취면적위7 cm×3 cm～13 cm× 7 cm.결과 술후6례각형천지피판전부성활,령1례피판원단출현렬개배사,잔류소창면경환약、이기전층피편이식유합.공、수구상구유합량호,경3개월지2년수방,색택、질지、외형급공능균회복교호.결론 응용족저각형천지피판,공구결손무수절취피편이식,유족저동원성후실견인피부수복,시수복족저부부중구연조직결손적일충교우월방법.
Objective To investigate the application of the plantar horn shaped fasciocutaneous perforator flaps for the reconstruction of the defects on heel and fore plantar.Methods The proximal end of the plantar fasciocutaneous perforator flaps were at the edge of defects.The deep fascia was cut off at the both sides of flaps.The plantar fascia should be included into the flaps.Then the flaps were rotated to cover the defects,containing two or three perforators.If necessary,the original supplying vessels could be cut off to facilitate the advancement of flaps.Results From Jan.2010 to Oct.2012,7 cases with plantar defects were treated with the horn shaped perforator flaps.The defects size ranged from 1.5 cm × 2.0 cm to 4.0 cm×5.0 cm with the size of the flaps ranging from 7 cm ×3 cm to 13 cm × 7 cm.All the flaps survived completely with primary healing both on donor and recipient sites.The flap color,texture,function and appearance were satisfactory during the follow-up period of 3-24 months.Conclusions The plantar horn shaped perforator flap can reconstruct the defects at plantar weight-bearing area with the similar thick skin tissue,which faciliates the functional reconstruction.No skin graft is necessary for the defect at donor site.
